bupivacaine hydrochloride anhydrous at a glance
Medicine class
Long-acting amide local anaesthetic
Licensed role
Spinal anaesthesia for specified lower-limb, urological and lower-abdominal surgery
Administration
Injected into the spinal fluid by an appropriately trained clinician
What is bupivacaine hydrochloride anhydrous used for?
The selected product is licensed for intrathecal spinal anaesthesia in adults and children of all ages.
Urological surgery
Lower-limb surgery, including hip surgery
Lower-abdominal surgery, including caesarean section
How does bupivacaine hydrochloride anhydrous work?
Bupivacaine reversibly blocks voltage-gated sodium channels in nerves. This stops electrical impulses travelling through the affected nerves, temporarily reducing sensation and pain; motor function may also be affected. The glucose-containing solution is hyperbaric, so gravity and patient position influence its initial spread within the spinal fluid.
bupivacaine hydrochloride anhydrous preparations and strengths
Injection
Route: Parenteral
Strengths: 5 mg/mL, 0.5% w/v
How to take bupivacaine hydrochloride anhydrous
This product is not taken by mouth or self-injected. A trained clinician injects it into the spinal fluid in a suitably staffed area with monitoring and resuscitation facilities. Move carefully and protect numb or weak areas until sensation and strength have returned; follow the hospital’s instructions about eating, drinking, activity and driving.
Tell the anaesthetic team about allergies, medical conditions and all medicines before the procedure.
Report pain, unexpected pins and needles, breathing difficulty or feeling faint during administration or recovery.
Do not walk without assistance until staff confirm that it is safe.
bupivacaine hydrochloride anhydrous side effects
Common or expected effects
- Low blood pressure, sometimes causing dizziness or nausea
- Slow heartbeat
- Nausea or vomiting
- Headache after spinal puncture
- Temporary difficulty passing urine or urinary incontinence
Get urgent medical advice
- Severe allergic reaction, including facial or throat swelling and breathing difficulty
- Extensive spinal block causing severe low blood pressure, slow heartbeat or breathing depression
- Seizures, abnormal heart rhythm, cardiovascular collapse or cardiac arrest from systemic toxicity
- New or persistent weakness, paralysis, altered sensation or other neurological symptoms
bupivacaine hydrochloride anhydrous in pregnancy
The selected product is licensed for spinal anaesthesia during caesarean section. Bupivacaine crosses the placenta, and late pregnancy increases susceptibility to an extensive spinal block, low blood pressure and slow heartbeat. An obstetric anaesthetist should therefore assess and monitor its use.
bupivacaine hydrochloride anhydrous while breastfeeding
Bupivacaine passes into breast milk in small quantities and the product information states that an effect on the child is generally not expected at therapeutic exposure. Tell the anaesthetic team that you are breastfeeding so your circumstances can be considered.
bupivacaine hydrochloride anhydrous interactions
The anaesthetic team should review all prescribed, non-prescribed and recently used medicines.
Other local anaesthetics or related amide antiarrhythmics, including lidocaine, mexiletine and tocainide
Toxic effects on the nervous system and heart may be additive.
Class III antiarrhythmics, including amiodarone
Cardiac effects may be additive, so close surveillance and ECG monitoring may be considered.
Cimetidine
May reduce bupivacaine clearance and increase exposure.
Common questions about bupivacaine hydrochloride anhydrous
Answers are fully visible for fast scanning and source review.
What is bupivacaine hydrochloride anhydrous used for?
The selected product produces spinal anaesthesia for specified lower-body and lower-abdominal operations, including caesarean section.
How is bupivacaine hydrochloride anhydrous given?
A trained clinician injects it into the spinal fluid; it is not swallowed or self-administered.
Is bupivacaine hydrochloride anhydrous a general anaesthetic?
No. It is a local anaesthetic that blocks sensation in part of the body, although sedation or a general anaesthetic may sometimes be used alongside spinal anaesthesia.
Sources
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Prepared and reviewed by the iatroX editorial team.