Ropivacaine is 60% as potent as Bupivacaine Ropivacaine is 60% as potent as Bupivacaine No difference in motor blockade, side effectsīupivacaine vs.
spontaneous labor)Ĭenter Only valid in labor epidural settingīupivacaine vs. Late labor (5cm cervical dilation)MLAC bupivacaine 0.140%ĭilation Values depend on patient population and the studyĬenter (parity, induction vs. MLAC increases with labor progressionEarly labor (2cm cervical dilation) Possible variations in dose-response curveĮD95 would be more clinically useful A snap-shot of labor pain at that particular cervical MLAC Limitations Designed only to obtain ED50 MLAC of lidocaine was 0.37% (95% CI 0.32-0.42) (Dixon and Massey formula)
MLAC- Bupivacaine/Lidocaine MLAC of bupivacaine was 0.065% (95% CI 0.045-0.085) Rejected: Unresponsive to initial or rescue dose (segmental pain, unilateral block etc) Ineffective: Unable to achieve VAPS of 10 or below but responsive to predetermined rescue dose MLACFirst Stage of Labor epidural requestCervical dilation not exceeding 5cmLumbar epidural, LOR saline (2ml)No test dose20mL bolus of solution over 5 minutesVAPS of 10 or below (0-100 range) within 60 minUp-Down sequential allocationĮffective: Achieve VAPS of 10 or below (0-100 range) Minimum Local Anesthetic Concentration (MLAC)Effective concentration in 50% of patients in 1st stage of labor (EC50)Clincial model to allow determination of relative potency of LAsAllow measurement of LA sparing effects of other drugs May contribute to maternal neurologic injury from malpositioning Why not just Local AnestheticsLocal anesthetics (LA) alone associated with Motor blockMotor Block associated with:
Increased instrumental deliverydecreased maternal satisfaction Why not just Local AnestheticsLocal anesthetics (LA) alone associated with Motor blockMotor block associated with: Why not just Local AnestheticsLocal anesthetics (LA) alone associated with Motor block Goals:Review Concept of MLACLocal anesthetic efficacyLocal anesthetic sparing effects: Pedram Aleshi MDThe Changing Practice of Anesthesia Half of Donny’s event is the meet and greet.Labor Epidural:Local Anesthetics and Beyond He performed in front of us to show how much he is very thankful. He made a public event for a meet and greet as part of his birthday celebration. Last time I check, to be able grant the wish of his fans which is to see him in person. Furthermore, though Donny is already famous, he is still a very humble person. At his age, he is not shy to still kiss his mom infront of his friends which many of us can’t do.
He always said that family must be always a priority, second to God. Moreover, he is a responsible son, a good brother to all his sibling and a supportive cousin. In fact, he is involved with many charity works, he will always find time to help those less fortunate people around him. He always care for the people around him. He is a very kind person with a genuine heart. Base on the interviews done to him he said that being a Last Septemhe participated in a charity "Bantay Bata 163's educational program" through the ABS-CBN Ball 2019.
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I can say that what he contributed to the society is how he has been a good role model and how he entertained people through his movies and TV shows. Donny is known today especially to the youth.
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