Adjuvants in Neuraxial Anesthesia

Opioids are the most common and the earliest-used local anesthetic adjuvants. The appropriate dose of opioids depends on the type of opioid (potency, efficacy, lipid solubility), indication for use, addition of other adjuvants, patient factors, and route of administration. Adrenaline is a vasoconstrictor used in neuraxial anesthesia. Sodium bicarbonate can be used to speed the onset of action of epidural lidocaine.