Marcaine Spinal Heavy solution for injection 5mg/ml 4ml ampoules, 5pcs

Composition

Active ingredients:

bupivacaine;

sodium monochloride;

Auxiliary substances:

sodium hydroxide and / or hydrochloric acid for pH correction;

water for injection

Pharmacological action

Marcaine Spinalheavy has a local anesthetic effect.

With intrathecal use, the effect occurs quickly, and its duration varies from medium to long. The duration of the effect depends on the dose.

Bupivacaine reversibly inhibits the conduction of impulses 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.

Use during pregnancy and lactation

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

Contraindications

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

Marcaine Spinalheavy is contraindicated for intravenous anesthesia by Beeru.

Side effects

• symptoms of excitement or depressing the Central nervous system (restlessness, anxiety, dizziness, tinnitus, blurred vision, tremor of the extremities, generalized convulsions),
• limb paralysis,
• paralysis of respiratory muscles,
• bradycardia,
• impairment of the function of sphincters,
• urinary retention,
• paresthesia and numbness of the limbs,
• impotence,
• reduced cardiac output,
• the blockade of the sinus node,
• hypotension,
• ventricular arrhythmias, including ventricular tachycardia,
• cardiac arrest.

Interaction

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

Local anesthetics increase CNS depression caused by drugs that depress the central nervous system. Anticoagulants (ardeparin, dalteparin, danaparoid, enoxaparin, heparin, warfarin) they increase the risk of bleeding.

When treating the injection site of a local anesthetic with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of soreness and swelling increases.

When using local anesthetic drugs for spinal and epidural anesthesia with guanadrel, guanethidine, mecamylamine, trimetafan, the risk of a pronounced decrease in blood pressure and bradycardia increases. Combination with general inhalation anesthesia with halothane increases the risk of cardiotoxicity of bupivacaine. Enhances and prolongs the effect of muscle-relaxing drugs. With narcotic analgesics, an additive effect develops, which is used during epidural anesthesia, but respiratory depression increases.

It shows antagonism with antimiasthenic drugs by their effect on skeletal muscles, especially when used in high doses, which requires additional correction of the treatment of myasthenia gravis. Cholinesterase inhibitors (antimiasthenic drugs, cyclophosphamide, demecarin, ecothiophate, isoflurophate, thiotepa) reduce the metabolism of local anesthetic drugs.

How to take, course of use and dosage

When performing epidural anesthesia, it is necessary to conduct a test dose with 3-5 ml. During the test dose for 5 minutes, it is necessary to maintain verbal contact with the patient and regularly determine the heart rate.

Aspiration should be performed before the main dose is administered, which should be administered slowly,25-50 mg / min under constant monitoring. When minimal toxic effects occur, further use is discontinued.

When used in adults,1-5 ml (2.5-12.5 mg) should be administered for trigeminal nerve block,10-20 ml (25-50 mg) for stellate ganglion block,20 ml (50 mg) first for long – term epidural anesthesia, then 6-16 ml (15-40 mg) every 4-6 hours,2-3 ml (10-15 mg) for intercostal block per nerve (10 nerves in total),15-30 ml for large blockages (sacral, brachial, etc. ) (75-150 mg).

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

The maximum recommended dose of the drug for a 4-hour period is 2 mg / kg (up to 150 mg). The maximum recommended dose is 400 mg / day. The total dose should be calculated based on the patient’s physical status.

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 the addition of epinephrine at the rate of 1: 200000).

Special instructions

Antidepressants increase the risk of low blood pressure.

Form of production

Solution for injection.

Storage conditions

At a temperature of 2-25 °C (do not freeze).

Shelf life

3 years

Active ingredient

Bupivacaine

Conditions of release from pharmacies

By prescription

Dosage form

solution for injection

Description

For adults as directed by your doctor

Indications

Anesthesia