Bupivacaine: functions, dosage, side effects, how to use it

What drug is Bupivacaine?

What is Bupivacaine for?

Bupivacaine is a drug with a function to block pain during medical and surgical procedures, including childbirth and dental surgery. This drug is classified as a class of drugs for local anesthetics or anesthetics. Bupivacaine is a drug that works by blocking the nervous system that sends pain signals to your brain.

The dosage of bupivacaine and the side effects of bupivacaine are detailed below.

How is Bupivacaine used?

The way to use bupivacaine is by injecting it directly into the area that will be numbed during the procedure. You will receive this injection at the dentist or hospital.

For epidural anesthesia, bupivacaine is given by injection in the lower lumbar region or the area around the spine.

For dental procedures, bupivacaine is injected directly into the gum near the area of ​​the tooth to be operated on.

Doctors and medical personnel will monitor your respiratory system, blood pressure, oxygen levels or vital signs while you are sedated with bupivacaine.

Some epidural anesthetics have long-lasting or permanent effects on several body functions such as sexual function, control of the digestive system and bladder, and the movement of your legs. Talk to your doctor about the risk of nervous system damage that may arise as a reaction to bupivacaine.

How is Bupivacaine stored?

The way to store bupivacaine is to be stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Bupivacaine dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dosage of Bupivacaine for adults?

Typical Dosage for Local Anesthesia

The dosage can be adjusted according to the patient's needs. However, the most commonly used dosage for bupivacaine is a single dose of up to 175 mg.

The dose can be given repeatedly every 3 hours and in one day, the maximum dose of bupivacaine is 400 mg.

• Local infiltrating anesthetic: 0.25% concentrate, injected up to the maximum dose
• Epidural block:
  • Concentrate 0.75%: Inject once at a rate of 75 - 150 mg (10 - 20 mL) for general anesthesia; not for anesthesia during labor
  • Concentrate 0.5%: Inject at a rate of 50 - 100 mg (10 - 20 mL) for a total local anesthetic; repeat the dose to enhance the anesthesia effect
  • Concentrate 0.25%: Inject at a rate of 25 - 50 mg (10 - 20 mL) for regional to local anesthesia; repeat the dose to enhance the anesthesia effect
• Epidural anesthesia: 0.5% and 0.75% concentrates should be given in doses of 3-5 mL between injections to detect the onset of poisoning or accidental intravascular or intrathecal injection.
• Epidural anesthesia for labor procedures: only 0.5% and 0.25% concentrates should be used during labor surgery; The 0.5% concentrate should be given in a dose of 3-5 mL and not to exceed 50-100 mg at each injection interval. For repeated doses should follow a test dose containing epinephrine if there are no contraindications; preservative-free products are recommended.
• Caudal block:
  • Concentrate 0.5%: Inject at a rate of 75 - 150 mg (15 - 30 mL) for a total local anesthetic; repeat the dose to enhance the anesthesia effect
  • Concentrate 0.25%: Inject at a rate of 3.75 - 75 mg (15 - 30 mL) under local anesthetic; repeat the dose to enhance the anesthesia effect
• Peripheral nerve blocks:
  • Concentrate 0.5%: Inject at a minimum dose of 25 mg (5 mL) up to the maximum dose allowed for total local anesthetic; repeat the dose to enhance the anesthesia effect.
  • Concentrate 0.25%: Inject at a minimum dose of 12.5 mg (5 mL) up to the maximum dose allowed for generalized local anesthesia; repeat the dose to enhance the anesthesia effect.
• Retrobulbar block: 0.75% concentrate: Inject at a rate of 15-30 mg (2 - 4 mL) for general anesthesia; repeat the dose to enhance the anesthesia effect
• Sympathetic block: 0.25% concentrate: Inject at a rate of 50 - 125 mg (20 - 50 mL)
• Bupivacaine in dextrose injection: Spinal anesthesia: Injected at a rate of 7.5 mg (1 mL) for lower and perineal area procedures, including procedures for removal of prostate tissue via the urethra (TURP) and surgical removal of the uterus; doses as low as 6 mg have been given for normal delivery.

The doses listed above are general dosage indicators for the average adult.

Typical dosage for C-section

• Bupivacaine in dextrose injection: Spinal anesthesia: Doses of 7.5 - 10.5 mg (1 - 1.4 mL) have been used.

What is the dosage of Bupivacaine for children?

Typical Dosage for Local Anesthesia

• Epidural block: 1.25 mg / kg / dose (use preservative-free products)
• Caudal block: 1 - 3.7 mg / kg (use preservative free products)
• Peripheral nerve block: Inject 0.25% or 0.5% concentrate (12.5 - 25 mg) at a dose of 5 mL; maximum allowed dose: 400 mg / day.
• Sympathetic block: Inject 0.25% concentrate at a dose of 20 - 50 mL (without epinephrine). Continuous epidural infusion (caudal or lumbar), always use preservative-free products: Initial dose: 2 - 2.5 mg / kg (0.25% bupivacaine solution at a dosage of 0.8 - 1 mL / kg).
• Infusion dose:
  • Infants younger than 4 months: 0.2 - 0.25 mg / kg / h;
  • Infants older than 4 months and young children: 0.4 - 0.5 mg / kg / d.
• Bupivacaine in dextrose injection: The use of this drug is not recommended for pediatric patients younger than 18.

In what dosage is Bupivacaine available?

Bupivacaine is available in the following forms:

• Concentrated solution, injection: 2.5mg / mL, 5 mg / mL, 7.5mg / mL

Bupivacaine side effects

What side effects can be experienced due to Bupivacaine?

Common side effects that may occur after using bupivacaine are nausea, vomiting, headache, back pain, dizziness or problems with sexual function.

Seek immediate medical help if you experience a severe allergic reaction while using this medicine. Symptoms of an allergic reaction that will appear when using bupivacaine are rash, blisters, itching, difficulty breathing, sneezing, severe dizziness, swelling of the mouth, face, lips, tongue or throat.

Immediately notify the nearest medical personnel if you experience more serious side effects, such as:

• Easily nervous, restless, confused or you feel like passing out
• Speech or vision problems
• Ringing in the ears, metal-like saliva, numbness or tingling in the mouth area or tremors
• Seizures
• Shortness of breath or shortness of breath
• Slow heart rate, weak pulse
• Urinating less frequently

Other side effects include:

• Nausea and vomiting
• Chills and trembling
• Headache
• Back pain

Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Bupivacaine Drug Warnings and Cautions

What should be known before using Bupivacaine?

It is not recommended to take this drug if you have had a severe allergic reaction to the anesthetic.

The drug bupivacaine is an anesthetic that is safe to use, but make sure you tell your doctor if you have:

• Anemia
• Kidney or liver disease
• Bleeding or blood clotting disorders
• Syphilis, polio, tumors of the brain or spinal cord
• Numbness or tingling
• Acute back pain, postoperative headache
• Low blood pressure or high blood pressure
• Crooked spine
• Arthritis

Is Bupivacaine safe for pregnant and lactating women?

There are no adequate studies regarding the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category C according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

A = Not at risk

B = No risk in several studies

C = May be risky

D = There is positive evidence of risk

X = Contraindicated

N = Unknown

Drug Interactions of Bupivacaine

What medicines may interact with Bupivacaine?

Drug interactions can change the performance of your medications or increase the risk of serious side effects. Not all possible drug interactions are listed in this document. Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change the dose of any medication without your doctor's approval.

Using this medication with some of the medicines below is usually not recommended, your doctor may not recommend that you continue using the drugs below or change your prescription according to your needs.

• Hyaluronidase
• Propofol
• Propranolol
• St. John's Wort
• Verapamil

In some cases, it may be necessary to take Carvedilol together with other medicines. If these medicines are prescribed for you, your doctor will usually change the dosage or determine how often you should take them.

• Alacepril
• Benazepril
• Captopril
• Cilazapril
• Delapril
• Enalaprilat
• Enalapril Maleate
• Fosinopril
• Imidapril
• Lisinopril
• Moexipril
• Pentopril
• Perindopril
• Quinapril
• Ramipril
• Spirapril
• Temocapril
• Trandolapril
• Zofenopril

Can food or alcohol interact with Bupivacaine?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions may interact with Bupivacaine?

Your health condition can affect the use of this drug. Always tell your doctor if you have other health problems, especially:

• Chondrolysis (disorders of the joints and bones) - may increase the risk of side effects
• Kidney illness; or
• Liver disease — Use it wisely. use it wisely. Side effects can increase due to decreased performance of the liver in excreting drug wastes in the body

Bupivacaine overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.