What are the contraindications of bupivacaine?
Who should not take BUPIVACAINE HCL?
- glucose-6-phosphate dehydrogenase (G6PD) deficiency.
- methemoglobinemia, a type of blood disorder.
- second degree atrioventricular heart block.
- slow heartbeat.
- significantly low blood pressure.
- severe liver disease.
How do you administer bupivacaine?
Bupivacaine hydrochloride injection, USP contains Bupivacaine hydrochloride, an amide local anesthetic, as the active pharmaceutical ingredient. The route of administration for Bupivacaine Hydrochloride injection is by injection, for infiltration, perineural, caudal, epidural, or retrobulbar use.
What is the mechanism of action of bupivacaine?
Bupivacaine is a local anesthetic. Local anesthetics block the generation and the conduction of nerve impulses by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential.
What are the contraindications that the nurse should be aware of when administering epidural anesthesia?
Contraindications to the use of a neuraxial (i.e., epidural or subarachnoid) technique include patient refusal, active maternal hemorrhage, septicemia, infection at or near the site of needle insertion and clinical signs of coagulopathy (Table 2).
Which nursing action is required before a client in labor receives an epidural anesthetic?
The nurse needs to monitor carefully the patient’s blood pressure throughout the entire period of epidural anesthesia. Any significant drop in maternal blood pressure causes a decrease in uterine blood flow which may result in fetal hypoxia.
Why is bupivacaine more cardiotoxic?
Maximum dose is 2.5 mg/kg. Bupivacaine is the most cardiotoxic of the LAs (Table 3.10), the cardiotoxic effects being enhanced by hypoxia, hypercapnia, acidosis and hyperkalaemia. It inhibits cardiac conductivity and contractility, and may induce ventricular fibrillation.
What are the indications of bupivacaine?
Bupivacaine is indicated for the production of local or regional anesthesia or analgesia for surgery, for oral surgery procedures, for diagnostic and therapeutic procedures, and for obstetrical procedures.
When is epidural anesthesia contraindicated?
Absolute contraindications to performing epidural injections include known hypersensitivity to agents, local or systemic infection, local malignancy, bleeding diathesis, congestive heart failure, and uncontrolled diabetes mellitus.
What should a nurse assess and do before an epidural?
Initial Assessment This will include the prescription and pump setting, the position of the epidural catheter, the sensory block (dermatome spread) and the motor block (Bromage). A pain assessment should also be documented at this time.
What are the side effects of bupivacaine hydrochloride in humans?
Body as a Whole: Hypersensitivity [cutaneous lesions, urticaria, sneezing, diaphoresis, syncope, hyperthermia, angioneurotic edema (including laryngeal edema), anaphylaxis, anaphylactoid reaction ]. CNS: Nervousness, unusual anxiety, excitement, dizziness, drowsiness, tremors, convulsions, unconsciousness, respiratory arrest.
When to use bupivacaine HCL before or after liposome?
Bupivacaine HCl, when injected immediately before bupivacaine liposome, may impact the pharmacokinetic and/or physicochemical properties when the mg dose of bupivacaine HCl solution exceeds 50% of the bupivacaine liposome dose Monitor Closely (1) bupivacaine will increase the level or effect of bupivacaine liposome by pharmacodynamic synergism.
How is bupivacaine related to other local anesthetics?
Bupivacaine is related chemically and pharmacologically to the aminoacyl local anesthetics. It is a homologue of mepivacaine and is chemically related to lidocaine. All three of these anesthetics contain an amide linkage between the aromatic nucleus and the amino, or piperidine group.
What happens to bupivacaine levels after an epinephrine injection?
After injection of MARCAINE for caudal, epidural, or peripheral nerve block in man, peak levels of bupivacaine in the blood are reached in 30 to 45 minutes, followed by a decline to insignificant levels during the next three to six hours.