APROPOSEDMATHEMATICALMODELFOR.ppt

* * * * * * * * * * * * BECAUSE LESS LOCAL ANESTHETIC MEANS: - Less sympathetic block - Less swings (?) in blood pressure - Less interventions needed from the anesthetist (fluids, ephedrine etc.) - Less useless motor block in the lower limbs - Faster recovery from the motor block and as a consequence the earlier neurological assessment should an inadvertent lesion have been produced. - Less concern for the patient that she doesn’t feel the legs - Less shivering in the PACU → more comfort for both the patient and the personnel. AND, YET, SOMETHING CAN GO WRONG - block not high enough – useless suffering - block not long enough – slow surgeon, adhesions, difficult baby extraction, OR dissfunctionalities etc. - unexpected intra operatory problems. - technical problems: using such “minute” quantities of LA, any lost drop can have a great influence on the whole parameters of the block. One of the accepted solutions to prevent all these: CSE. This method is used today. It can be applied as any continuous method. All depends on the specific policy of every hospital. I prefer to be an optimist that is sometimes wrong than a pessimist that is always right! SO, WHAT DO YOU THINK? SO, WHAT DO YOU THINK? Questions anyone? * * * * * * * * * * * * * * * * * * * * * * * * * A PROPOSED MATHEMATICAL MODEL FOR CALCULATING LOCAL ANESTHETIC DOSESFOR CESAREAN SECTIONS(AND NOT ONLY) Dr. Paul Zilberman paulzi60@ 2010 Foreword to the reader This presentation is the result of many years of clinical observation corroborated with a constant search for a common denominator among many biological variables. It must be stated from the start that this presentation is not a clinical research and, as such, it should be regarded only as another clinical tool that could be used in daily practice, but, BY NO MEANS A CLINICAL GUIDELINE. It is the sole responsibility of the reader to adapt the conclusions of this presentation in her/his current practice. The reader is strongly encouraged, before