Local and Regional Anesthesia in the Elderly

Bolus

Infusion

Midazolam 0.5–2 mg (titrated up to 0.07 mg/kg)

Remifentanil 0.05–0.0625 μg/kg/min

Fentanyl 0.25–0.5 μg/kg

Propofol 1.5–3 mg/kg/h (25–50 μg/kg/min)

Ketamine 0.1–0.2 mg/kg

Dexmedetomidine 0.2–0.7 μg/kg/h

Table 17.2

Suggested anesthetic doses for nerve block

Nerve block and drug	Bolus dose	Infusion	Useful adjunct
Spinal
Isobaric bupivacaine	5–15 mg	N/A	Epinephrine 0.3 mg
			Morphine 0.1 mg
			Fentanyl 10–25 μg
Epidural
Bupivacaine	0.5 %, 5–10 mL	0.125 %, 5–10 mL/h	Morphine 0.05–0.1 mg/mL
			Fentanyl 1–2 μg/mL
Levobupivacaine	0.5 %, 5–10 mL	0.125 %, 5–10 mL/h	Morphine 0.05–1 mg/mL
			Fentanyl 1–2 μg/mL
Ropivacaine	0.5 %, 5–10 mL	0.2 %, 5–10 mL/h	Morphine 0.05–1 mg/mL
			Fentanyl 1-2 μg/mL
Peripheral
Bupivacaine	0.5 %, 20 mL	0.2 %, 5–10 mL	N/A
Levobupivacaine	0.5 %, 20 mL	0.2 %, 5–10 mL	N/A
Ropivacaine	0.5 %, 20 mL	0.2 %, 5–10 mL	N/A

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