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