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BupivacaineA Review of 2,077 Cases
Daniel C. Moore, MD;
L. Donald Bridenbaugh, MD;
Phillip O. Bridenbaugh, MD;
Geoffrey T. Tucker, PhD
JAMA. 1970;214(4):713-718.
Abstract
Bupivacaine (LAC 43, Marcaine [Sweden]) hydrochloride, a long-acting local anesthetic agent in concentrations of 0.1%, 0.25%, 0.5%, and 0.75% with and without a vasoconstrictor drug, was used in caudal, epidural, and peripheral nerve block. Onset occurred in 4 to 10 minutes and maximum analgesia in 15 to 30 minutes. Concentrations of 0.25%, 0.5%, and 0.75% consistently produced excellent sensory anesthesia, but only 0.75% consistently produced profound motor relaxation needed for intra-abdominal surgery. However, 0.25% and 0.5% were satisfactory in caudal, epidural, and peripheral nerve block for (1) pain relief of labor; (2) vaginal delivery; (3) perineal surgery; and (4) extremity surgery. Two inadvertent intravenous injections of 100 and 120 mg of bupivacaine hydrochloride caused mild systemic toxic reactions but no untoward sequelae. One inadvertent subarachnoid injection of 110 mg resulted in a total spinal block with an uneventful recovery.
Author Affiliations
From Mason Clinic and Virginia Mason Research Center, Seattle.
Footnotes
Reprint requests to 1118 Ninth Ave, Seattle 98101 (Dr. Moore).
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