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.

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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