Page 32 - CASA Bulletin of Anesthesiology 2019 Issue 6

CASA Bulletin of Anesthesiology

问题讨论 PBLD

Exparel

Q1: 各位同行，怎样用exparel in tap block? Tall, standard
weight . How much for each side? Thanks（ Jack Zhang ）
1 . 10 ml Exparel mixed with 10 ml of 0 .25% bupivacaine on
each side . ( 李金蕾 )
2 . 现在是不是越来越多的骨科医生都不要求做nerve blocks?
他们都用exparel ,觉得效果比nerve blocks 好。(Jeff Huang )
3 . 是有这个倾向。( 汪红 西弗吉尼亚大学 )
4 . Exparel is quite expensive . Wonder if insurance covers it .
( 杨少华 )

Q2: 双侧TAP and rectus Sheath block, 0 .5 % of Bupivacaine 30ml, 10ml exparel on each side ，
术中低血压，是LA toxicity 吗？可以用intralipid 治疗吗？ ( 杨少华 )
1 . 神志消失、肌肉小震颤、用升压药无效可以辅助诊断。( 徐旭仲 温医大附属一院 )

Q3: 在全麻中，需要phenylephrine 滴注。升压药剂量偏大，补液充分，难维持血压，尿少。
用intralipid后，TAP还有作用吗？ ( 杨少华 )
那很难说，升压药有效一般不是。如果同时心动过缓或心律失常也可试验性给予20长链
脂肪乳剂100ml。脂质治疗不会影响局麻效果。( 徐旭仲 )

Q4: I got this today . Experal is officially approved for interscalene nerve block! How about adc
block? I am going to use exparel for interscalene nerve block . Any quick recipe? Suggestions ?
( Jack Zhang )
Only mix with bupivacaine, most use half exparel and half bupivacaine . ( 李金蕾 )

Q5: Is 0 .5% ropivacaine ok? ( Jack Zhang )
The only compatible local is bupivacaine . ( 李金蕾 )

Q6: Does anybody have experience with adductor canal block with Exparel? ( JC )
Yes，Need volume . 20 ml minimum . ( 汪红 )

Q7: Do you mix Exparel with Bupivacaine? ( JC )
Yes . If I need more than 20 ml . ( 汪红 )

Q8: Do you do it preop or postop? ( JC )
Preop . ( 汪红 )

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