Bupivacaine (Marcaine, Sensorcaine)

Category:

  • Local anesthetic

Description:

  • Local anesthetic

Indications:

  • Local or regional anesthesia, analgesia for surgery, oral surgical procedures

  • Diagnostic and therapeutic procedures, obstetrical procedures

Contraindications:

  • Obstetrical paracervical block anesthesia

Precautions:

  • Pregnancy category C

  • IV regional anesthesia, obstetrical anesthesia (75% concentration)

  • Hypotension, heart block, impaired cardiovascular function

  • Use in head and neck area, retrobulbar blocks, elderly, anaphylaxis

Adverse Reactions (Side Effects):

  • CNS: anxiety, disorientation, drowsiness, restlessness, seizures, shivering, tremors,loss of consciousness

  • CV: bradycardia, cardiac arrest, dysrhythmias, fetal bradycardia, hypotension, myocardia depression

  • EENT: blurred vision, miosis, tinnitus

  • GI: nausea, vomiting

  • RESP: respiratory arrest

  • SKIN: allergic reactions, burning, edema, rash, skin discoloration at injection site, tissue necrosis, urticaria  

Dosage:

Dose varies with procedure, depth of anesthesia, vascularity of tissues, duration of anesthesia, and condition of patient

  • Adult:   

    • Caudal block: 

      • INJ 15-30ml of 0.25% or 0.5%

    • Epidural block: 

      • INJ 10-20ml of 0.25% or 0.5%

    • Peripheral nerve block: 

      • INJ 5ml of 0.25% or 0.5% (12.5-25mg)

      • max 2.5 mg/kg or 400mg daily

    • Sympathetic nerve block: 

      • INJ 20-50ml of 0.25%

  • Child:   

    • Caudal block: 

      • INJ 1-3.7 mg/kg

    • Epidural block: 

      • INJ 1.25 mg/kg/dose

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