bupivacaine hydrochloride at a glance
Medicine class
Long-acting amide local anaesthetic
Main roles
Local or regional anaesthesia and relief of labour, surgical or postoperative pain
Administration
Given by a suitably trained clinician; patients do not administer it themselves
After treatment
Move carefully while numb and follow the clinical team's advice about driving and machinery
What is bupivacaine hydrochloride used for?
Selected UK products are licensed for:
Local infiltration or injection around a nerve to produce local or regional anaesthesia.
Epidural or caudal blockade for surgical anaesthesia, including obstetric surgery.
Acute pain relief during labour or after an operation.
Continuous epidural infusion for labour analgesia or postoperative pain control.
The injection product is also licensed for diagnostic and therapeutic sympathetic nerve blocks in chronic pain.
How does bupivacaine hydrochloride work?
Bupivacaine reduces sodium movement through nerve-cell membranes, temporarily preventing pain impulses from being generated and carried along nearby nerves. Its effect on movement depends on the site and depth of the block.
bupivacaine hydrochloride preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 0.1% w/v, 0.125% w/v
Injection
Route: Parenteral
Strengths: 2.5 mg/mL, 5 mg/mL, 0.25% w/v, 0.5% w/v
How to take bupivacaine hydrochloride
A clinician administers bupivacaine hydrochloride by injection, nerve block, epidural or epidural infusion as appropriate. Do not handle an epidural pump or catheter yourself. Protect the numb area from pressure, heat and injury, and move carefully until normal sensation and movement return.
Tell the clinical team about allergies, heart rhythm problems, liver or kidney disease, bleeding disorders and all medicines taken.
Immediately report unexpected pain, spreading weakness, breathing difficulty or symptoms of toxicity.
Follow procedure-specific instructions about eating, drinking, mobility and travel home.
bupivacaine hydrochloride side effects
Common or expected effects
- Low blood pressure, which may cause dizziness or light-headedness
- Feeling sick or vomiting
- Pins and needles or altered sensation
- Dizziness
- Slow heartbeat
- Difficulty passing urine
- Temporary soreness, bruising or continuing numbness around the treated area
Get urgent medical advice
- Severe allergy with facial or throat swelling, widespread raised rash or breathing difficulty
- Local-anaesthetic toxicity causing mouth tingling, tongue numbness, ringing in the ears, visual disturbance, twitching, confusion or seizures
- Breathing depression, profound weakness or an unexpectedly high spinal block
- Abnormal heart rhythm, severe low blood pressure, loss of consciousness or cardiac arrest
- Persistent or worsening weakness, numbness, or bladder or bowel disturbance suggesting nerve injury
bupivacaine hydrochloride in pregnancy
Selected products are licensed for labour analgesia and obstetric surgery. Product information advises use in early pregnancy only when the expected benefit outweighs the risk. The obstetric and anaesthetic team must assess route-specific maternal and fetal risks.
bupivacaine hydrochloride while breastfeeding
Bupivacaine passes into breast milk in small amounts. UK product information considers therapeutic exposure unlikely to affect the child, and NHS guidance states that local anaesthetics are generally compatible with breastfeeding. Seek specialist advice for a premature or unwell infant or complex medicine combinations.
bupivacaine hydrochloride interactions
The clinical team should review all medicines before regional or epidural anaesthesia.
Other amide local anaesthetics, including lidocaine
Systemic toxic effects can add together, requiring careful assessment of total exposure and toxicity signs.
Mexiletine and related anti-arrhythmics
Structural similarity to amide local anaesthetics may increase additive neurological or cardiac toxicity.
Common questions about bupivacaine hydrochloride
Answers are fully visible for fast scanning and source review.
What is bupivacaine hydrochloride used for?
It numbs a specific area or blocks nearby nerves for surgery and pain relief, including epidural pain control during labour or after an operation.
Is bupivacaine hydrochloride a general anaesthetic?
No. It is a local anaesthetic used to numb part of the body; other medicines may be used separately for sedation or general anaesthesia.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.