Bupivacaine

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