By Tom Heaton
This week it was my turn to present a paper at our local journal club. After a bit of searching for an exciting paper, I settled on this paper looking at the effect of age on spinal anaesthetic dose requirements. ‘The Effect of Age on the Median Effective Dose (ED50) of Intrathecally Administered Plain Bupivacaine for Motor Block’ was looking at an area of anaesthetic practice that I had been meaning to look into for a while; namely to see what evidence was out there about the factors that impact on the effectiveness of spinals. This interest was piqued by some recent reading around hip fracture management, including the National Hip Fracture Database Sprint Audit, which highlight problems with intraoperative hypotension as well as the rather large range of local anaesthetic doses used. How low can we go with our doses? Is there any point in going low with them? What factors impact on the dose we give? This paper starts having a look at this topic with some interesting results.
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