Two aspects of the study of continuous spinal anaesthesia (CSA) for caesarean section by Alonso and colleagues deserve comment. Despite excluding technical failures, the authors observed a high failure rate (12/94) when even 15 mg of bupivacaine with fentanyl 20 ug did not result in the desired level of block: T4 to cold. Fifteen milligrams of bupivacaine is well above the ED 95 (13.6 mg) for attaining a T5 block to touch with a single-shot spinal.
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