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Reply to letter: Low-dose spinal anesthesia for cesarean delivery: Have we gone too far?

To the Editor:

I appreciate the interest of Drs. Hepner et al. in our work. The use of intrathecal low-dose local anesthetic (LA) in combination with opioids for surgical anesthesia is not a resurgence of an old practice of using low doses of LA for spinal anesthesia. It is actually a relatively new technique born of the evidence for synergism between intrathecal LA and opioids. Perhaps their apprehension about the technique stems from this misunderstanding. Like any technique, this one has both advantages and disadvantages. Its advantages include greater hemodynamic stability, but without compromising the sensory level of anesthesia. I do, however, agree that the risk of high spinal ...

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