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British Journal of Anaesthesia 2005 95(3):427; doi:10.1093/bja/aei584
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org

CORRESPONDENCE

Minimum effective local anaesthetic dose for spinal anaesthesia

E-mail: j.a.w.wildsmith{at}dundee.ac.uk

Editor—In their response1 to my criticisms2 of their paper3 Sell and colleagues accept some of my points, and refute others. On most of the latter we will simply have to agree to differ, but, not surprisingly, I cannot accept their quoting my own review4 in support of their belief that the solutions which they used were isobaric! Their quote from the article (‘Given the normal variation [of CSF], it is necessary that solutions that are to be predictably hypobaric or hyperbaric in all patients have baricities below 0.9990 or above 1.0010 respectively’) is correct, but it is taken out of context, and ignores the key relevance of the words ‘given the variability...’ and ‘predictably’, to say nothing of the arguments that follow in the rest of that paragraph.

These lead to the specific conclusion that the word ‘plain’ is a more appropriate descriptor so I would ask them to consider the paragraph in full, not just a selective quote.

J. A. W. Wildsmith

Dundee, UK

References

1 Sell A, Olkkola KT, Jalonen J, Aantaa R. Correspondence: minimum effective local anaesthetic dose for spinal anasesthesia. Br J Anaesth 2005; 94: 865–6[Free Full Text]

2 Wildsmith JAW. Correspondence: minimum effective local anaesthetic dose for spinal anasesthesia. Br J Anaesth 2005; 94: 865[Free Full Text]

3 Sell A, Olkkola KT, Jalonen J, Aantaa R. Minimum effective local anaesthetic dose for spinal anasesthesia. Br J Anaesth 2005; 94: 239–42[Abstract/Free Full Text]

4 Hocking G, Wildsmith JAW. Intrathecal drug spread. Br J Anaesth 2004; 93: 568–78[Free Full Text]


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