Anaesthesia, Epidural

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Click here to access the Adult Hospital Level Chapter 12: Anaesthesiology and Intensive Care with supporting NEMLC Report_2025-9-Version-1.0_26-February-2026

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• Only preservative free medicines may be used.
• Local anaesthetics are administered through a catheter inserted into the epidural space at a spinal level appropriate for the surgery.
• Aspiration and a test dose (2–3 mL) of local anaesthetic should be given to confirm catheter not intravascular or intrathecal. Subsequent doses should be fractionated (3–5 mL boluses).
• Bupivacaine 0.5%.
  • Onset ±10 minutes.
  • Duration ±4 hours.
  • Motor block is less with lower concentrations.
  • Maximum dose 2 mg/kg.

LoE:III³⁶

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2024 Edition