Bupivacaine

General
  • Type: Local anesthetics
  • Dosage Forms: injectable solution
  • Dosage Strengths: 0.25%, 0.5%, 0.75%
  • Routes of administration: Infiltration
  • Common Trade Names: Marcaine, Sensorcaine

Maximum Doses of Anesthetic Agents
Agent Without Epinephrine With Epinephrine Duration Notes
Lidocaine5 mg/kg (max 300mg)7 mg/kg (max 500mg)30-90 min
  • 1% soln contains 10 mg/ml
  • 2% soln contains 20 mg/ml
Mepivicaine7 mg/kg8 mg/kg
Bupivicaine2.5 mg/kg (max 175mg)3 mg/kg (max 225mg)6-8 hr
  • 0.5% soln contains 5 mg/ml
  • May cause cardiac arrest if injected intravascularly
  • Do not buffer with bicarbonate
Ropivacaine3 mg/kg
Prilocaine6 mg/kg
Tetracaine1 mg/kg1.5 mg/kg3hrs (10hrs with epi)
Procaine7 mg/kg10 mg/kg30min (90min with epi)

Adult Dosing


Pediatric Dosing


Special Populations
  • Pregnancy Rating: C
  • Lactation: Infant risk is minimal
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Contraindications
  • Allergy to class/drug
  • Obstetric paracervical block

Adverse Reactions

Serious
  • Negative ionotropy, hypotension, cardiac arrest
  • Respiratory arrest
  • CNS depression, CNS excitation, bacterial meningitis, seizure

Common

Pharmacology
  • Half-life: ~3-8 hours
  • Metabolism: Liver
  • Excretion:

Mechanism of Action
  • Amide-type local anesthetic; stabilizes the neuronal membranes → blocks initiation and transmission of nerve impulses

See Also
  • Local Anesthetic Systemic Toxicity (LAST)

References
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