Marcaine Spinal Heavy, 5 mg/ml 4 ml 5 pcs

Marcaine Spinal Heavy has a local anesthetic effect.

In intrathecal administration the effect is rapid and its duration varies from medium to long. The duration of the effect depends on the dose.

Bupivacaine reversibly inhibits impulse conduction along the nerve fiber by blocking the passage of sodium ions through the cell membrane.

Indications

Caudal, epidural, lumbar and conduction (in dentistry), retrobulbar anesthesia, sympathetic blockade.

Active ingredient

Composition

Active ingredients:

Bupivacaine;

Sodium monochloride;

Auxiliary substances:

sodium hydroxide and/or hydrochloric acid to correct pH;

water for injection

How to take, the dosage

When an epidural anesthesia is administered, a test dose of 3-5 ml should be given. During the test dose, verbal contact with the patient should be maintained for 5 min and the heart rate should be determined regularly.

Aspiration should be performed prior to administration of the main dose, which should be administered slowly, 25-50 mg/min under constant monitoring. If minimal toxic effects occur, further administration should be discontinued.

When used in adults for trigeminal nerve blockade, 1-5 ml (2.5-12.5 mg), for stellate ganglion blockade 10-20 ml (25-50 mg), for prolonged epidural anesthesia 20 ml (50 mg) first, then 6-16 ml (15-40 mg) every 4-6 h, for intercostal blockade 2-3 ml (10-15 mg) per nerve (10 nerves total), for large blocks (sacral, brachial, etc.) 15- 30 ml (75-150 mg).

For anesthesia in obstetrics, the following initial doses are used (may be repeated every 2-3 h): for epidural and caudal anesthesia (for vaginal delivery and vacuum-extraction), 6-10 ml (15-25 mg); for epidural block for cesarean section, 15-30 ml (75-150 mg); for bilateral pudendal blockade, 5-10 ml (12.5-25 mg).

The maximum recommended doses of the drug during a 4 h period are 2 mg/kg (up to 150 mg). The maximum recommended dose is 400 mg/day. The total dose should be calculated taking into account the physical status of the patient.

The concentration of the solution used depends on the type of anesthesia: infiltration – 0.25%, conduction – 0.25-0.5%, retrobulbar – 0.75%, sympathetic block – 0.25%, epidural lumbar anesthesia – 0.25-0.75%, caudal – 0.25-0.5%, conduction – 0.5% (with epinephrine added at the rate of 1:200000).

Interaction

Use with MAO inhibitors (furazolidone, procarbazine, selegelin) increases the risk of excessive BP reduction. Vasoconstrictors (epinephrine, methoxamine, phenylephrine) prolong the local anesthetic effect of low-concentration (0.125-0.25%) solutions of bupivacaine.

Local anesthetics increase CNS depression caused by CNS depressant drugs. Anticoagulants (ardeparin, dalteparin, danaparoid, enoxaparin, heparin, warfarin) increase the risk of bleeding.

The treatment of the local anesthetic injection site with disinfectant solutions containing heavy metals increases the risk of local reaction in the form of soreness and swelling.

The use of local anesthetic drugs for spinal and epidural anesthesia with guanadrel, guanethidine, mecamylamine, trimethaphan increases the risk of marked BP reduction and bradycardia. Combination with halothane general inhalation anesthesia increases the risk of bupivacaine cardiotoxicity. Increases and prolongs the effect of myorelaxant drugs. With narcotic analgesics – it develops additive effect, which is used for epidural anesthesia, but it increases respiratory depression.

Shows antagonism with anti-myasthenic drugs in action on the skeletal musculature, especially when used in high doses, which requires additional correction of myasthenia gravis treatment. Cholinesterase inhibitors (antimyasthenic drugs, cyclophosphamide, demecarine, ecothiofate, isoflurofate, thiotepa) reduce the metabolism of local anesthetic drugs.

Special Instructions

Antidepressants increase the risk of lower blood pressure.

Contraindications

Hypersensitivity to any of the components of the drug or to other local anesthetics of the amide type.

Marcaine Spinal Heavy is contraindicated in the administration of Bier intravenous anesthesia.

Side effects

Pregnancy use

With caution – pregnancy, lactation and children under 12 years of age.