Bupivacaine

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Bupivacaine Brand Names

Marcaine | Sensorcaine | Sensorcaine MPF

What is Bupivacaine

Bupivacaine is a long-acting local anesthetic of the amide type recommended for local or regional anesthesia.

Bupivacaine’s onset of action is rapid (1—10 minutes), and its duration is significantly longer (3—9 hours) than other commonly used local anesthetics.

Also, analgesia persists longer than anesthesia, which postpones the need for postoperative narcotics.

Bupivacaine is available in multiple forms including sterile isotonic solutions with or without the preservative methyl paraben, and hyperbaric solutions consisting of bupivacaine hydrochloride in dextran.

All forms are available with epinephrine. Bupivacaine received FDA approval in 1972.

Indications

  1. Caesarean section anesthesia
  2. caudal anesthesia
  3. dental anesthesia
  4. epidural anesthesia
  5. infiltration anesthesia
  6. local anesthesia
  7. obstetric anesthesia
  8. ophthalmic anesthesia
  9. peripheral nerve block
  10. retrobulbar nerve block
  11. spinal anesthesia
  12. sympathetic nerve block

Side Effects

  1. anaphylactoid reactions
  2. angioedema
  3. anxiety
  4. apnea
  5. arachnoiditis
  6. arrhythmia exacerbation
  7. AV block
  8. back pain
  9. blurred vision
  10. bradycardia
  11. cardiac arrest
  12. chills
  13. chondrolysis
  14. cranial nerve palsies
  15. decreased uterine contractility
  16. dizziness
  17. drowsiness
  18. dysgeusia
  19. erythema
  20. fecal incontinence
  21. fetal acidosis
  22. fetal bradycardia
  23. fetal death
  24. fever
  25. headache
  26. hyperhidrosis
  27. hypotension
  28. hypoventilation
  29. injection site reaction
  30. laryngeal edema
  31. malignant hyperthermia
  32. meningitis
  33. metallic taste
  34. methemoglobinemia
  35. miosis
  36. muscle paralysis
  37. nausea
  38. palpitations
  39. paresthesias
  40. pruritus
  41. respiratory arrest
  42. restlessness
  43. seizures
  44. shivering
  45. sinus tachycardia
  46. sneezing
  47. syncope
  48. tinnitus
  49. tremor
  50. urinary incontinence
  51. urinary retention
  52. urticaria
  53. ventricular fibrillation
  54. ventricular tachycardia
  55. vomiting
  56. weakness

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • amide local anesthetic hypersensitivity
  • anticoagulant therapy
  • AV block
  • bleeding
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • cardiogenic shock
  • children
  • coagulopathy
  • continuous intraarticular infusion administration
  • dehydration
  • eclampsia
  • electrolyte imbalance
  • epidural anesthesia
  • fetal distress
  • fetal prematurity
  • G6PD deficiency
  • geriatric
  • head and neck anesthesia
  • headache
  • heart failure
  • hemorrhagic shock
  • hepatic disease
  • hypertension
  • hypotension
  • hypovolemia
  • infants
  • infection
  • intraarterial administration
  • intrathecal administration
  • intravenous administration
  • labor
  • malignant hyperthermia
  • methemoglobinemia
  • myasthenia gravis
  • neonates
  • neurological disease
  • obstetric delivery
  • ocular surgery
  • paraben hypersensitivity
  • paracervical nerve block
  • pregnancy
  • pudendal nerve block
  • pulmonary disease
  • renal disease
  • renal impairment
  • requires a specialized care setting
  • requires an experienced clinician
  • seizure disorder
  • seizures
  • sepsis
  • shock
  • spinal anesthesia
  • thrombocytopenia

Interactions

  • Acebutolol
  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Alfentanil
  • Ambenonium Chloride
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amobarbital
  • Amprenavir
  • Amyl Nitrite
  • Aprepitant, Fosaprepitant
  • Articaine; Epinephrine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atracurium
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Bendroflumethiazide; Nadolol
  • Benzhydrocodone; Acetaminophen
  • Benzocaine
  • Benzocaine; Butamben; Tetracaine
  • Benzonatate
  • Betaxolol
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Boceprevir
  • Brimonidine; Timolol
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Bupivacaine; Lidocaine
  • Butabarbital
  • Caffeine; Ergotamine
  • Carbamazepine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carteolol
  • Carvedilol
  • Chloroprocaine
  • Chloroquine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Cholinesterase inhibitors
  • Ciprofloxacin
  • Cisatracurium
  • Clomipramine
  • Cobicistat
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Conivaptan
  • Cyclophosphamide
  • Dapsone
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desipramine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dihydroergotamine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Donepezil
  • Donepezil; Memantine
  • Dorzolamide; Timolol
  • Doxacurium
  • Doxepin
  • Edrophonium
  • Elbasvir; Grazoprevir
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enflurane
  • Ergoloid Mesylates
  • Ergonovine
  • Ergot alkaloids
  • Ergotamine
  • Erythromycin; Sulfisoxazole
  • Esmolol
  • Etomidate
  • Fentanyl
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Flutamide
  • Fluvoxamine
  • Fosamprenavir
  • Fospropofol
  • Galantamine
  • General anesthetics
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Halothane
  • Homatropine; Hydrocodone
  • Hyaluronidase
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hydantoins
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyurea
  • Ibuprofen; Oxycodone
  • Idelalisib
  • Ifosfamide
  • Imatinib
  • Imipramine
  • Indinavir
  • Isavuconazonium
  • Isocarboxazid
  • Isoflurane
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Itraconazole
  • Ketamine
  • Ketoconazole
  • Labetalol
  • Lesinurad
  • Lesinurad; Allopurinol
  • Levomethadyl
  • Levorphanol
  • Lidocaine
  • Lopinavir; Ritonavir
  • Magnesium Salts
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Mepivacaine
  • Mepivacaine; Levonordefrin
  • Methadone
  • Methohexital
  • Methylergonovine
  • Methysergide
  • Metoclopramide
  • Metoprolol
  • Minocycline
  • Mitotane
  • Mivacurium
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nadolol
  • Nebivolol
  • Nebivolol; Valsartan
  • Nefazodone
  • Nelfinavir
  • Neostigmine
  • Neuromuscular blockers
  • Nevirapine
  • Nitrates
  • Nitrofurantoin
  • Nitroglycerin
  • Nortriptyline
  • Ombitasvir; Paritaprevir; Ritonavir
  • Oritavancin
  • Oxycodone
  • Oxymorphone
  • Pancuronium
  • Pazopanib
  • Penbutolol
  • Penicillin G Benzathine; Penicillin G Procaine
  • Penicillin G Procaine
  • Pentobarbital
  • Pergolide
  • Perphenazine; Amitriptyline
  • Phenelzine
  • Phenobarbital
  • Physostigmine
  • Pindolol
  • Posaconazole
  • Povidone-Iodine
  • Prilocaine
  • Prilocaine; Epinephrine
  • Primaquine
  • Primidone
  • Procarbazine
  • Propofol
  • Propoxyphene
  • Propranolol
  • Protriptyline
  • Pyridostigmine
  • Pyrimethamine; Sulfadoxine
  • Quinine
  • Rapacuronium
  • Rasburicase
  • Remifentanil
  • Rifamycins
  • Ritonavir
  • Rituximab; Hyaluronidase
  • Rivastigmine
  • Rocuronium
  • Ropivacaine
  • Secobarbital
  • Selegiline
  • Sevoflurane
  • Simeprevir
  • Succinylcholine
  • Sufentanil
  • Sulfadiazine
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfasalazine
  • Sulfisoxazole
  • Sulfonamides
  • Tacrine
  • Telaprevir
  • Telithromycin
  • Telotristat Ethyl
  • Tetracaine
  • Thiopental
  • Timolol
  • Tipranavir
  • Trandolapril; Verapamil
  • Tranylcypromine
  • Trastuzumab; Hyaluronidase
  • Tricyclic antidepressants
  • Trimipramine
  • Tubocurarine
  • Valproic Acid, Divalproex Sodium
  • Vecuronium
  • Verapamil
  • Voriconazole

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