SpinalDose — Mugurkaula anestēzija

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Lee S et al. · Scientific Reports 2021 · n=401 · R²=0.72

ENobservational

Level (segments from S5) = 7.12 + 0.88 × dose (mg) + 1.59 × sex ← ♀=1, ♂=0 − 0.11 × (height − 162) cm + 0.05 × (weight − 68) kg + K_age K_age: <75 yr → +0.00 | 75–85 yr → +0.95 | >85 yr → +2.57

Harten JM et al. · Anaesthesia 2005 · RCT

ENRCT

Volume (ml, 0.5% hyperbaric bupivacaine) = 1.0 + (height − 150) × 0.009 + (weight − 50) × 0.003 Dose (mg) = Volume × 5 Piemērs / Example: 165 cm, 75 kg: = 1.0 + 0.135 + 0.075 = 1.21 ml → 6.05 mg

Carpenter RL et al. · Anesthesiology 1992 · n=952

ENobservational

Dose (mg) = K × height (cm) K by target level: S2–S5 → 0.05 | T10 → 0.07 T6 → 0.09 | T4 → 0.10 Piemērs: 170 cm, T10: 170 × 0.07 = 11.9 mg

SFAR · SEDAR · Miller's Anesthesia 9th ed. · Expert consensus

ENESFRconsensus

Final dose = Base dose × K_age × K_height × K_BMI × K_sex K_age: <60 yr → ×1.00 | 60–70 → ×0.85 | 70–80 → ×0.75 | >80 → ×0.65 K_height: <150cm → ×0.80 | 150–160 → ×0.90 | 160–175 → ×1.00 | >175 → ×1.10 K_BMI: <25 → ×1.00 | 25–35 → ×0.90 | >35 → ×0.80 K_sex: Male / Vīrietis → ×1.00 | Female / Sieviete → ×0.93 Piemērs: 75 g.v. (×0.75) · 155 cm (×0.90) · ĶMI 30 (×0.90) → K = 0.608 Base 12 mg × 0.608 = 7.3 mg

Stienstra R, Greene NM · Regional Anesthesia 1991

ENconsensus

Dose (mg) = K_seg × n_segments n_segments = injection level − target level L3–L4 → T6: 17 − 6 = 11 segments K_seg: Hyperbaric bupi → 0.10–0.12 mg/segment Isobaric bupi → 0.12–0.15 mg/segment

Carpenter RL · Anesthesiology 1998 · MRI study

ENobservational

Lumbosacral CSF volume: 28–81 ml (median ~45 ml) LA concentration ∝ 1 / CSF_volume Factors reducing CSF volume: Obesity (BMI >30) → −10–15 ml Pregnancy → −15–20 ml Age >70 yr → −5–10 ml Lumbar stenosis → −10–25 ml

	S2–S5	T10	T6	T4			TNS

Hyperbaric bupivacaine 0.5% / 8% dextrose	4–6 mg 0.8–1.2 ml	7.5–12.5 mg 1.5–2.5 ml	10–13 mg 2.0–2.6 ml	12–15 mg 2.4–3.0 ml	3–5 min	90–150 min	<1%
Isobaric bupivacaine 0.5% plain	—	10–15 mg 2.0–3.0 ml	12–17.5 mg 2.4–3.5 ml	15–20 mg 3.0–4.0 ml	5–8 min	120–180 min	<1%
Levobupivacaine 0.5% isobaric	—	10–12.5 mg	12–15 mg	12.5–17.5 mg	3–5 min	90–150 min	<1%
Ropivacaine 0.5–0.75% isobaric	—	15–17.5 mg	17.5–20 mg	20–22.5 mg	4–6 min	90–120 min	<1%

Hyperbaric prilocaine 2%	10–30 mg 0.5–1.5 ml	40–50 mg 2.0–2.5 ml	50–60 mg 2.5–3.0 ml	≤60 mg max	3–4 min	60–90 min	<1%
2-Chloroprocaine 1% preservative-free	20–30 mg	30–40 mg	40–50 mg	≤60 mg	3–5 min	40–60 min	~0%

Lidocaine 2–5% hyperbaric	25–30 mg	50–60 mg	60–75 mg	75–100 mg max 100 mg	2–3 min	60–90 min	10–40%
Mepivacaine 1.5–2% isobaric	—	45–52 mg	52–60 mg	≤60 mg	3–5 min	90–120 min	6–8%



Fentanyl	10–25 µg	+30–60 min	2–4 h
Sufentanil	2.5–5 µg	+30–60 min	2–4 h

Morphine	KS: 100 µg Liela ķir.: 100–300 µg Max 300–500 µg		18–24 h

Clonidine	15–75 µg (parasti 30–45 µg)	+45–75 min	4–6 h
Dexmedetomidine	3–10 µg (opt: 5 µg)	+120–180 min	6–8 h