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Contraindications
Patient w/ active CNS disease (e.g. meningitis, intracranial haemorrhage), TB of the spine, pyogenic infection on inj site, pre-anaesth elevated intracranial pressure. Not intended for IV regional anaesth (Bier's block) and paracervical block in obstetrics; obstetric epidural block (0.75% soln).
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Special Precautions
Patient w/ partial or complete heart block, impaired CV function and hypovolaemia; marked obesity, senility, cerebral atheroma, myocardial degeneration, toxaemia (epidural and spinal anaesth). May cause chondrolysis when given via intra-articular continuous infusion. Severe hepatic impairment. Pregnancy and lactation. Patient Counselling May temporarily impair locomotion and alertness. Monitoring Parameters Monitor CV and resp vital signs, state of consciousness, signs of CNS toxicity.
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Adverse Reactions
Bradycardia, hypotension, HTN, nausea, vomiting, diplopia, neuropathy, peripheral nerve injury, arachnoiditis, paresis and paraplegia, signs of CNS toxicity (e.g. convulsions, paraesthesia, tremor), dizziness, allergic reactions.
Potentially Fatal: Cardiac arrhythmia, cardiac and resp arrest. |
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Drug Interactions
Additive systemic toxic effect w/ other local anaesth or agents structurally related to amide-type local anaesth (e.g. lidocaine and mexiletine). Increased risk of myocardial depression w/ antiarrhythmics. Enhanced adverse effects w/ hyaluronidase. Decreased clearance resulting to increased plasma concentrations w/ cimetidine and ranitidine. Increased risk of adverse effects w/ β-blockers and Ca channel blockers.
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CIMS Class
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ATC Classification
N01BB01 - bupivacaine ; Belongs to the class of amides. Used as local anesthetics.
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