DRUG STUDY

Name of Student Nurse: Angelica D. Mendoza Date: February 22, 2022

Block/Group: 2BSN-05 Clinical Instructor: Prof. Diana Prince Clara Campos Bautista

Dosage, Route,
Name of Drug Frequency, and Mechanism of Action Indication Adverse Reactions Special Nursing Responsibilities
Timing Precautions
Generic: Dosage: Local anesthetics inhibit Contraindications Side Effects concurrent use of Assessment
initiation and conduction Local or regional Seizure, other local 1. Systemic Toxicity:
Bupivacaine of sensory nerve anesthesia or Cardiovascular anesthetics; Liver Assess for systemic
Hydrochloride Route: impulses by altering the analgesia for collapse, disease; toxicity (circumoral
influx of sodium and surgical, obstetric, Respiratory arrest, Concurrent use of tingling and
Brand: efflux of potassium in or diagnostic anticoagulants numbness, ringing
Frequency: neurons, slowing or procedures (including low- in ears, metallic
Sensorcaine stopping pain dose heparin and taste, dizziness,
transmission. Epidural anesthetics; Liver blurred vision,
Timing: administration allows Hypersensitivity; ↓ BP, bradycardia, disease; tremors, slow
Classification action to take place at the cross dizziness, anxiety, Concurrent use of speech, irritability,
Functional: level of the spinal nerve sensitivity with anticoagulants twitching, seizures,
roots immediately
restlessness, (including low- cardiac
other amide local
Epidural local adjacent to the site of anesthetics dose heparin/ dysrhythmias) each
anesthetics administration. The may occur; heprinoids) shift. Report to
catheter is placed as close Bupivacaine physician or other
Chemical: as possible to the contains bisulfites health care
dermatomes (skin surface and should be professional.
areas innervated by a avoided in patients 2. Orthostatic
single spinal nerve or with known Hypotension:
group of spinal nerves) intolerance. Monitor blood
that, when blocked, will Decreased BP, pressure, heart rate,
produce effective spread shock & and respiratory rate
of analgesia for the site arrhythmias, continuously while
of injury. local infections at patient is receiving
Therapeutic Effects: anesthesia site, this medication.
Decreased pain or Mild hypotension
induction of anesthesia; is common because
low doses have minimal of the effect of
effect on sensory or local anesthetic
motor function; higher block of nerve
doses may produce fibers on the
complete motor blockade sympathetic
nervous system,
Source: Deglin J.H., causing
Vallerand A.H (2008) ; vasodilation.
Drug Guide for Nurses Significant hypo
11th Edition; F.A. Davis tension and
Company; Pages 478-480 bradycardia may
occur, especially
when rising from a
prone position or
following large
dose increases or
boluses. Treatment
of unresolved
hypotension may
include hydration,
decreasing the
epidural rate,
and/or removal of
local anesthetic
from analgesic
solution.
3. Unwanted Motor
and Sensory
Deficit: The goal
of adding low-dose
local anesthetics to
epidural opioids for
pain management
is to provide
analgesia, not to
produce anesthesia.
Patients should be
able to ambulate if
their condition
allows, and
epidural analgesic
should not hamper
this important
recovery activity.
However, many
factors, including
location of the
epidural catheter,
local anesthetic
dose, and
variability in
patient response,
can result in
patients
experiencing
unwanted motor
and sensory
deficits. Pain is the
first sensation lost,
followed by
 temperature, touch,
proprioception, and
skeletal muscle
tone
4. Assess for sensory
deficit every shift.
Ask pa tient to
point to numb and
tingling skin areas
(numbness and
tingling at the
incision site is
common and
usually normal).
Notify physician or
other health care
professional of un
wanted motor and
sensory deficits.
5. Unwanted motor
and sensory deficits
often can be
corrected with
simple treatment.
For example, a
change in position
may relieve nor
extremity muscle
weakness is often
treated by
decreasing the
epidural infusion
rate and keeping
the patient in bed
 until the weakness
resolves.
Sometimes
removing the local
anesthetic from the
analgesic solution
is necessary, such
as when signs of
local anesthetic
toxicity are
detected or when
simple treatment of
motor and sensory
deficits has been
unsuccessful.
6. Advise patient to
request assistance
during ambulation
until orthostatic
hypotension and
motor deficits are
ruled out.
7. Patients
receiving these
blocks should
have their
circulation and
respiration
monitored and be
constantly
observed.
8. Resuscitative
 equipment and
personnel for
treating adverse
reactions should
be immediately
available.
9. Dosage
recommendation
s should not be
exceeded
10.