Ultracaine Heavy Injection
Bupivacaine
5mg
Jayson
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Indications
Ultracaine Heavy Injection is used for:
Local anesthesia, Epidural, Intrathecal anesthesia, Epidural analgesia
Adult Dose
Adult: Inj Percutaneous infiltration anesth For prolonged action: 9 mg w/ adrenaline (1 in 200,000), may repeat 2-10 mins later if needed. Max: 90 mg per dental sitting.
Surgical anaesthesia
Peripheral nerve block 12.5 mg (as 0.25% soln) or 25 mg (as 0.5% soln) . Max: 150 mg/dose.
Sympathetic nerve block As 0.25% soln: 50-125 mg.
Retrobulbar block As 0.75% soln: 15-30 mg.
Caudal block In surgery: 37.5-75 mg (as 0.25% soln) or 75-150 mg (as 0.5% soln).
Lumbar epidural block In surgery: 25-50 mg (as 0.25% soln) and 50-100 mg (as 0.5% soln).
Spinal block: 0.5% soln: 10-20 mg (2-4 mL).
Acute pain
Adult: Lumbar block in labour pain: 0.25% soln: 15-30 mg (6-12 mL); 0.375% soln: 22.5-45 mg (6-12 mL); 0.5% soln: 30-60 mg (6-12 mL).
Alternatively, 0.1% soln: 10-15 mg (10-15 mL) per hr; 0.125% soln: 10-15 mg (8-12 mL) per hr via infusion.
Caudal block in labour pain: 0.25% soln: 25-50 mg (10-20 mL); 0.375% soln: 37.5-75 mg (10-20 mL); 0.5% soln: 50-100 mg (10-20 mL).
Child Dose
<12 years: Not recommended
Caudal Block, Epidural Block, Local Block
>12 years
Local Anesthesia: Infiltration 0.25% infiltrated locally: 175 mg maximum
Caudal Block: 15-30 mL of 0.25% or 0.5% (preservative free)
Epidural Block Other Than Caudal Block: 10-20 mL of 0.25% or 0.5%; administer in 3-5 mL increments allowing sufficient time to detect toxic manifestations of inadvertent IV or IT administration (preservative free); for surgical procedures requiring high degree of muscle relaxation and prolonged effects administer10-20 mL of 0.75%; not to be used in obstetrical cases
Peripheral or Sympathetic Nerve Block
>12 years
Peripheral Nerve Block: 5 mL of 0.25-0.5%; 400 mg/day maximum
Sympathetic Nerve Block: 20-50 mL of 0.25%
Renal Dose
Administration
Contra Indications
Hypersensitivity to local anaesthetics of amide type. IV regional anaesthesia; paracervical block in obstetrics; spinal anaesthesia <18 yr. Lactation. Solutions containing preservatives for caudal or epidural block.
Precautions
Hepatic disease; CV disease; children <12 yr; pregnancy. Elderly and debilitated patients.
Lactation: excretion in milk unknown/not recommended
Pregnancy-Lactation
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/ beta-blockers and Ca channel blockers.
Adverse Effects
Side effects of Bupivacaine :
CNS excitation may be followed by depression. Hypotension, bradycardia, arrhythmias and cardiac arrest; methaemoglobinaemia; seizures, restlessness, dizziness. Hypersensitivity. Prolonged block, Edema, Headache, Hypotension, Hypoventilation, Nausea, Nervousness, Palpitation, Respiratory arrest, Tachycardia, Tinnitus, Tremors, Vomiting
Potentially Fatal: Cardiac and sudden respiratory arrest.
Mechanism of Action
Bupivacaine blocks both the initiation and conduction of nerve impulses reducing the permeability of neuronal membranes to Na ions resulting in inhibition of depolarization w/ resultant blockade of conduction.
Note
Ultracaine Heavy 5mg Injection manufactured by Jayson. Its generic name is Bupivacaine. Ultracaine Heavy is availble in Nepal.
Farmaco Nepal drug index information on Ultracaine Heavy Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.