Anesthesiology and Intensive Care

 Mixtures  of  local  anesthetics  for  regional  anesthesia  are sometimes used in an effort to compensate for the short duration of action of certain rapidly acting agents such as chloroprocaine and lidocaine, and the long latency of longer-acting  agents such as tetracaine and  bupivacaine. Mixtures of chloroprocaine and bupivacaine theoretically offer significant clinical  advantages because  of the rapid onset and low systemic toxicity of chloroprocaine and the long duration of action of bupivacaine; however, clinical results in studies of combinations have been mixed. The use of catheter techniques for many forms of regional anesthesia makes it  possible to begin  with a rapid-onset  local anesthetic such as lidocaine, mepivacaine, or  chloroprocaine and then follow with an infusion of either a shorter-acting or longeracting local anesthetic  thereafter. Clinicians  should be cautioned to not use maximum doses of two local anesthetics in combination in the mistaken belief that th

  HEART RHYTHM CONTROL STRATEGY:

1 Give supplemental oxygen to achieve SpO2 ≥ 90%. 2 Intubate if SpO2 not maintained or altered mental state. 3 Get a 12-lead ECG and screen for STEMI equivalents using right side and posterior leads as appropriate.