Perineal Tear Repair

Regional · 1 h

NeuraxialSpinal

0.5% bupivacaine + 8% glucose2ml

diamorphine0.3mg

Start phenylephrine100mcg/ml, target normotension once spinal is administered

or

NeuraxialEpidural Top-Up

2% Lidocaine + 1:200,000 Adrenaline10ml

fentanyl75mcg, epidural

or

NeuraxialEpidural Top-Up

0.5% Bupivacaine10ml

fentanyl75mcg, epidural

Infusions

If required phenylephrineTitrate to effect

Antibiotics as per surgical team

Analgesia

Paracetamol1g
Diclofenac100mg, PR

Prescriptions

Paracetamol1g, QDS
Ibuprofen400mg, TDS
Dihydrocodeine30mg, QDS PRN
Ondansetron4mg

Details

Specialty: Obstetrics
Author: Gas Cookbook
Procedure: Epidural Spinal
Updated: Jun 2026

Example plan written by a clinician, not medical advice. Check every dose against the BNF and your local protocols and adapt to the patient in front of you. You remain responsible for every clinical decision. Disclaimer · Report an error

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Intra-op

Post-op

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