Epidural ropivacaine+fentanyl with epinephrine

PLEASE NOTE:   Posts made to this forum should not be considered as the expressed opinions of, nor should be considered endorsed by, the Medication Safety Officer’s Society (MSOS) or the Institute for Safe Medication Practices (ISMP). 

Make sure your email is up-to-date
In order to continue to receive updates from MSOS, as well as forum posts and other valuable information as a member of MSOS, please be sure to update your email address with us, whenever it changes. If you need assistance doing so, please send an email to jrufo@ismp.org

2 posts / 0 new
Last post
Serge Maltais
Serge Maltais's picture
Offline
Last seen: 3 days 4 hours ago
Joined: 11/20/2018 - 13:36
Epidural ropivacaine+fentanyl with epinephrine

Hi,

Following a transcription error in the pharmacy system, a rarely prescribed ropivacaine/fentanyl epidural with epinephrine was prepared and administered instead of the regular preparation without epinephrine, which could have contributed to the patient's variation in her blood pressure during the administration. We decided to withdraw this presentation from the selection as we concluded that the cause of the error was related to an obsolete/unnecessary formula in our system. Essentially the epinephrin is added to apparently boost the effect of the epidural, and the anesthesists insist that there is a need for it, but we are not convinced that the benefit outweight the risk here.

We would be grateful to those of you who analyzed this risk and would like to share your conclusion with us.

Thanks.