the patchy block

Often described as a missed segment.

Patient may feel like pain is worse than before epidural, but all focused on one small patch.

Suggested techniques to improve patchy block:

  • roll patient on poor block side down and bolus/PCEA

  • give small bolus of more concentrated local anaesthetic (e.g. 5ml 0.25%)

  • consider resiting if failing to resolve, particularly if theatre is on the cards

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