Bupivacaine Hcl

It is a long acting and is used for obstetric epidural block. It has slow onset of action, taking upto 30 minutes for full effect.

Indications

Infiltration, block, caudal, epidural, lumbor anaesthesia with long duration of action.

Dosage

Max. dose is 150 mg in a 4-hour period.

Contra-Indications

Intravenous regional anaes-thesia. Digital block.

Special Precautions

Cardiovascular diseases, Elderly, debilitated patients. Shock, heart block, hepatic impairment. Drug interaction occurs with phenothiazines, MAOIS, general anaesthetics. Paediatrics: Not recommended below age 12 years. Pregnancy: Use only, if clearly indicated. Lactation: Use with caution. Elderly: Reduced dose necessary.

Side Effects

Cardiac arrests, CNS depression, apnoea, hypotension, bradycardia, arrhythmias, persistent neurological deficits despite anaesthetic recovery. Allergy/angioneurotic oedema/ rashes/ laryngeal oedema/ pyrexia.

Drug Interactions

May potentiate systemic toxicity of other amide local anaesthetics, lignocaine and mepivacaine. Reduced clearance with cimetidine and ranitidine.