{
  "abstract": "Background and Aims Spinal anaesthesia for obstetric surgery often includes low-dose morphine, where dosing accuracy is critical to balance analgesia and side effects. Despite this, no standardised preparation technique exists, and the impact of dead space and needle choice is often overlooked.Methods Anaesthetists were asked to prepare spinal drugs (bupivacaine, fentanyl, morphine) using water-filled ampoules and their usual technique. Syringes were weighed to assess dose accuracy and dead space. Participants’ use of filter needles, preparation steps, and time taken were recorded. An educational intervention followed, highlighting the effect of dead space and demonstrating a technique to minimise discrepancies and reduce contamination risk. Participants repeated the preparation, and post-intervention data and perceptions were collected.Results Morphine dosing discrepancies ranged from 23.5% to 91%, largely due to dead space and preparation technique. Drawing both opioids together, failing to clear syringes/needles, and improper filter needle use contributed significantly. Post-intervention, average morphine dose error reduced from 38.2% to 6.7%. While 80% of participants were open to changing their practice, 67% noted the new method was slower. Filter needle use was inconsistent: 33% used a hypodermic needle to draw opioids, and 17% inappropriately used a filter needle to transfer drugs.Abstract EP086 Table 1Participant experience (n=12)Abstract EP086 Table 2Spinal preparation timeAbstract EP086 Table 3Dosing accuracy: pre- vs. post-interventionConclusions This study highlights significant variation in spinal drug preparation and the risks posed by dead space. A simple educational intervention improved dosing accuracy. While not prescriptive, adopting a more standardised approach may enhance both safety and efficacy in spinal anaesthesia preparation.",
  "authors": [
    {
      "affiliations": [
        "Anaesthesiology Fellow, The Coombe Hospital, Dublin 8, Dublin, Smithfield, Ireland"
      ],
      "name": "Eanna O’Sullivan"
    },
    {
      "affiliations": [
        "Anaesthesiology Consultant, The Coombe Hospital, Dublin 8, Dublin, Dublin, Ireland"
      ],
      "name": "Terry Tan"
    }
  ],
  "title": "EP086 Optimising accuracy in spinal drug preparation: the role of dead space and filter needles",
  "uid": "d73b5d3b-e2e9-57ad-be79-7cd5b3b421f6"
}