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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