Other Brands/Names

Decain, Buvathetic, Buvanest Spinal 0,5% Heavy, Buvanest, Bupivacain Spinal, Bupiloc Spinal 0,5% Heavy, Bupican Heavy, Bupican, Bunascan Spinal 0,5% Heavy,  Bucain Spinal.

How It Works

Bupivacaine hydrochloride blocks the transmission of pain impulses from the nerves to the brain, providing temporary relief from the pain.

Indications

Bupivacaine hydrochloride is used as an analgesic (a medicine that relieves pain), as an anesthetic during surgical procedures, and as pain relievers for post-surgical procedures.

Contraindication

• Central nervous system diseases, such as meningitis (infection-related inflammation of the meninges that protect the brain and spinal cord) and intracranial hemorrhage.

• Spinal tuberculosis (TB), a bacterial infection caused by Mycobacterium tuberculosis that infect the spine.

• Severe infection at the injection site (often accompanied with pus discharge).

• Increased intracranial pressure.

Side Effects

• Bradycardia (slow heart rate)

• Hypotension (low blood pressure)

• Hypertension (high blood pressure)

• Nausea, vomiting, dizziness

• Diplopia (double vision that makes a person see two images of one object)

• Neuropathy (nerve damage/disorder that can lead to numbness, pain, weakness, or tingling sensation, typically felt in the hands or feet)

• Arachnoiditis (inflammation of the arachnoid membrane lining the brain and spinal cord)

• Paraplegia (paralysis of the lower body from the pelvis to the feet)

• Signs of central nervous system toxicity (e.g., seizures, paresthesias/tingling, tremors/uncontrolled shaking)

• Allergic reactions

• Potentially fatal adverse reactions: irregular heart rhythm/arrhythmias, cardiac arrest, and respiratory arrest

Types

Bupivacaine hydrochloride is available as injectable drugs; the administration of this drug can only be performed by physicians or healthcare personnels under a physician’s supervision.

Dosage

Analgesic (pain relief)

• Adults, labor analgesia:

  • 0.25% solution: 15–30 mg (6–12 mL)

  • 0.375% solution: 22.5–45 mg (6–12 mL)

  • 0.5% solution: 30–60 mg (6–12 mL)

• Children (1–12 years old):

  • 0.25% solution: 1.5–2 mg/kg

  • 0.25% or 0.5% solution: 0.5–2 mg/kg

Post-operative pain relief

• 0.1% solution: 4–15 mg (4–15 mL) per hour

• 0.125% solution: 5–15 mg (4–12 mL) per hour

Preoperative anesthetic

• Local anesthesia: 0.25% solution up to a maximum of 150 mg (60 mL)

Safety

• Pregnancy category C: animal studies have shown adverse fetal effects, but there are no adequate controlled studies in pregnant women.
• This medicine is excreted into breast milk. Consult a doctor before breastfeeding.

Drug Interactions

• Increased adverse effects with other local anesthetics such as lidocaine and mexiletine.

• Higher risk of myocardial effects when it is combined with antiarrhythmic medicines.

• Greater side effects if this drug interacts with hyaluronidase (a genetically engineered protein).

• Increased blood levels of bupivacaine hydrochloride with antacids or PPI such as cimetidine and ranitidine.

• Increased risks of side effects with antihypertensive medications such as beta-blockers and calcium channel blockers.

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