CRIs

CRIs

Postby drphilzeltzman » Sun Aug 15, 2010 12:28 am

Hello,

I am wondering if you use CRIs (Constant Rate Infusions) in your practice.

If not, then why not? Do you have any worries or questions?

If you do, when do you use them?

Phil
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Re: CRIs

Postby dogdoctor » Wed Sep 08, 2010 3:36 pm

Hi Phil!
I use CRI's fairly often in surgery - probably not as often as I "should"!
Mostly I use ketamine CRI's for virtually all non "routine" surgeries - i.e. not typically used in ovariohysterectomies, castrations, routine dental cleanings, and small skin/SQ tumor removals. I will use a ketamine CRI for most other surgeries.
I use lidocaine in the CRI for surgeries in which I would anticipate arrhythmic events - e.g. splenectomy/GDV.
I occasionally use morphine in the CRI, but not usually - mostly due to other concurrent opioids on board with pre-medications and desire to keep things fairly "simple" in my anesthesia.
I use ketamine the most as a CRI agent because I've been told that there are virtually no contraindications for its use!
--Dan--
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Re: CRIs

Postby MBA » Thu Sep 09, 2010 8:18 am

In practices where I have worked, I have seen MLK CRI's used for surgeries where recovery is expected to be very painful, such as IVDD surgery. Also phenylephrine CRI's for patients whose BP was very low during anesthetized procedures and epinephrine CRI's for patients with very low heart rate.

The main drawback seems to be staff comfort with preparing them, so a simple "recipe" and lots of training and practice are very important. A standard formulation where dosage delivery is controlled by flow rate seems to be the most comfortable for staff.

MBA
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