Original Date of issue: 01/11/2005 Last eviewed: 01/05/2011 Version:4 Page 1 of 7 15: Anaesthesia 15.1 General anaesthesia 15.1.1 Intravenous anaesthesia Etomidate Injection (20mg/10ml) Ketamine Injection (200mg/20ml, 1g/10ml) Propofol-Lipuro Injection 1% (200mg/20ml, 1g/100ml) Propofol-Lipuro Injection 2% (1g/50ml) Thiopental Injection (500mg) Propofol Syringe (500mg/50ml) estriction eserved for training purposes under direction of Consultant Anaesthetist. 15.1.2 Inhalational anaesthetics Nitrous oxide Isoflurane (250ml) Sevoflurane (250ml) estriction S Desflurane (240ml) For the maintenance of anaesthesia in obese or elderly, confused patients by anaesthetists trained in low-flow technique. Halothane (250ml) eserved for children with croup and epiglottitis 15.1.3 Antimuscarinic drugs Atropine Miniject (1mg/10ml, 1mg/5ml) Atropine Injection (600micrograms/1ml) Glycopyrronium Injection (200micrograms/1ml) Hyoscine hydrobromide (400micrograms/ml)
Original Date of issue: 01/11/2005 Last eviewed: 01/05/2011 Version:4 Page 2 of 7 15.1.4 Sedative and analgesic peri-operative drugs 15.1.4.1 Anxiolytics and neuroleptics Midazolam Injection (2mg/2ml) estriction Midazolam Injection (5mg/5ml) Used in A&E, Catherter Lab, adiology, Endoscopy and Wards for conscious sedation. Midazolam Injection (10mg/2ml) Midazolam Injection (50mg in 10ml) eserved for use in 1. Aseptics for preparation of syringes, 2. Theatre 4 to sedate small children who are to be transferred for urgent care 3. Ward 20 for oraol buccal anaesthesia preoperatively for some patient attending for dental treatment 4. Harden Ward for subcutaneous administration in palliative care 5. Psychiatric wards Bradford District care Trust as a temporary alternative to lorazepam injection for sedation of violent or aggressive patients eserved for sedation of patients in transit who are being transferred to other hospitals. Stock to be kept in theatre recovery only. Temazepam Tablets 10mg eserved for premedication before surgery. See BNF section 4.1.1 for other indications 15.1.4.2 Non-opioid analgesics estriction C Ketorolac Trometamol Consultant Anaesthetists use only
Original Date of issue: 01/11/2005 Last eviewed: 01/05/2011 Version:4 Page 3 of 7 Injection (10mg/1ml, 30mg/1ml) C Parecoxib Injection 40mg Consultant Anaesthetists use only
Original Date of issue: 01/11/2005 Last eviewed: 01/05/2011 Version:4 Page 4 of 7 Opioid analgesics Fentanyl Injection (100micrograms/2ml) Fentanyl 2micrograms/ml with Bupivacaine 0.1% 250ml Fentanyl 2micrograms/ml with Levobupivicaine 0.1% in sodium chloride 0.9% 250ml estriction Alfentanil Injection 1mg/2ml, For theatre and ICU use only. 5mg/1ml,5mg/10ml Alfentanil Nasal Spray 5mg/5ml For palliative care consultant s use only (ward 3) Alfentanil Injection 5mg/1ml For palliative care consultant s use only (ward 3 and ICU) C emifentanil Injection (1mg) emifentanil Injection (2mg) For use in laparoscopic surgery and head injury patients undergoing CT scans 15.1.5 Neuromuscular blocking drugs Atracurium Injection (25mg/2.5ml, 50mg/5ml, 250mg/25ml) Mivacurium injection (10mg/5ml) Pancuronium Injection (4mg/2ml) ocuronium Injection (50mg/5ml) Suxamethonium Injection (100mg/2ml) Vecuronium Injection (10mg) 15.1.6 Drugs for reversal of neuromuscular blockade Neostigmine Injection 2.5mg/ml Neostigmine 2.5mg/ml with Glycopyrridium 500micrograms/ml (obinul- Neostigmine) S S Edrophonium Injection (10mg /1ml) Sugammadex Injection 100mg/ml (2ml and 5ml) estriction For use by anaesthetists and neurologists Approved for the emergency reversal of rocuronium and vecuronium and in situations where surgery has been
Original Date of issue: 01/11/2005 Last eviewed: 01/05/2011 Version:4 Page 5 of 7 discontinued prematurely. A 12-month audit of use of sugammadex should be carried out. 15.1.7 Antagonists for central and respiratory depression Flumazenil Injection (500micrograms/5ml) Naloxone Injection (40micrograms/2ml, 400micrograms/1ml) Naloxone Syringe (2mg/2ml) 15.1.8 Drugs for malignant hyperthermia estriction S Dantrolene Injection (20mg) Used for malignant hypothermia. All our stock is in theatre. It is used fairly rarely but, when it is used, large quantities may be required. We have an arrangement with Bradford oyal Infirmary that we can borrow their stock if necessary. 15.2 Local anaesthesia Bupivacaine 20mg Glucose 320mg/4ml Spinal Injection Emla Cream (5g) with dressings (Lidocaine 2.5%/Prilocaine 2.5%) Ethyl chloride spray Instillagel Syringe (6ml, 11ml) Levobupivicaine 25mg/10ml Levobupivicaine 50mg/10ml (single wrap) Levobupivicaine 50mg/10ml (double wrap) Lidocaine (Lignocaine) 10% Spray (50ml) Lidocaine 4% Topical Solution (40ml) Lidocaine 1% Injection (2ml, 5ml, 10ml, 20ml) Lidocaine 1% Miniject (10ml) Lidocaine 1% Adrenaline 1:200,000 Injection (20ml) Lidocaine 2% Adrenaline 1:200,000 Injection (20ml) Lidocaine 2% Injection (2ml, 5ml, 20ml) Lidocaine 2% Adrenaline 1:80,000 cartridge (2.2ml) Prilocaine 1% Injection (50ml) Prilocaine 3% felypressin cartridge (2.2ml)
Original Date of issue: 01/11/2005 Last eviewed: 01/05/2011 Version:4 Page 6 of 7 Tetracaine 4% Gel with Dressings (Ametop) Tetracaine 4% Gel without Dressings (Ametop)
Original Date of issue: 01/11/2005 Last eviewed: 01/05/2011 Version:4 Page 7 of 7 C Articaine with adrenaline 1 in 100,000 (Septanest) Articaine with adrenaline 1 in 200,000 (Septanest) estriction Gynaecology consultants only S Bupivicaine 0.5% Epinephrine Theatre use only (Adrenaline) 1:200,000 (10ml) Bupivicaine 0.25% Epinephrine (Adrenaline) 1:200,000 (10ml) S Instilla Quill For Family Planning Clinics only C C Lidocaine 5% medicated plasters Lidocaine 5% + Phenylephrine 0.5% Nasal Spray Mepivacaine Injection 3% (2.2ml cartridge) S Prilocaine hydrochloride 20mg, Glucose 60mg/ml spinal injection (5ml) For the treatment of neuropathic pain in cancer patients in whom pregabalin / gabapentin have been ineffective/not tolerated. Prescribing restricted to Consultants in Haematology, Oncology and Palliative Care. Use is to be audited Consultant ENT surgeons and anaesthetists performing awake fibreoptic intubations. eserved for use by chiropodists For use by anaesthetic department only for short procedures below the umbilicus.