If during childbirth obstetrician decided necessary STI caesarean section, and in the epidural space has a catheter, through which the anesthetized childbirth, need to enter the epidural full dose (mean 20 mL) of local anesthetic concentration, The necessity of mine for intraoperanionnogo anesthesia: chloroprocaine — 3%, or lidocaine — 2%, or bupivacaine (bucain) —0.5%, or ropivacaine (naropin) —0.75%. A smaller dose will not provide sufficient anesthesia.
If a cesarean section needs to be started very quickly, it is better to administer docaine rather than bupivacaine or ropivacaine, with the addition of adrenaline 1: 200,000 (then anesthesia will come faster). If time does not allow you to enter the test dose according to all the rules (with a 5-minute wait), lidocaine is administered slowly (no faster than 1 ml in 5 seconds). When manifestations of subarachnoid (deep anesthesia) or intravasal ingestion of a local anesthetic (metallic taste in the mouth, ringing in the ears, dizziness, bradycardia or tachycardia), its administration is immediately stopped. If a catheter is not inserted into the epidural space, if an emergency cesarean section is needed, it is better to perform a spinal anesthesia (its effect will come much faster and it will be deeper) or general anesthesia.