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Like lidocaine, bupivacaine is an amino-amide anesthetic; the aromatic head and the hydrocarbon chain are linked by an amide bond rather than an ester as in earlier local anesthetics. As a result, the amino-amide anesthetics are more stable and less likely to cause allergic reactions.
In the European Union, the combination bupivacaine/meloxicam is indicated for treatment of somatic postoperative pain from small- to medium-sized surgical wounds in adults. [ 2 ] In the United States it is indicated for soft tissue or periarticular instillation to produce postsurgical analgesia for up to 72 hours after bunionectomy, open ...
E.g. of amide LA: lidocaine, prilocaine, articaine, mepivacaine; E.g. of ester LA: benzocaine, procaine; Genuine allergic reactions of an amide LA is very uncommon. An ester LA is more possible to result in an allergic reaction because the compound will be broken down to para-aminobenzoic acid (PABA) which is a trigger for allergic reactions. [30]
It is generally safe to use in those allergic to tetracaine or benzocaine. [9] Lidocaine is an antiarrhythmic medication of the class Ib type. [8] This means it works by blocking sodium channels thus decreasing the rate of contractions of the heart. [11] [8] When injected near nerves, the nerves cannot conduct signals to or from the brain. [9]
lidocaine [12] [13] (lignocaine) Xylocaine 1943 (Nils Löfgren and Bengt Lundqvist) 1947 (Torsten Gordh) mepivacaine: Carbocaine, Polocaine 1956 (Ekenstam and Egner) 1957 (Dhuner) meprylcaine: Epirocain metabutoxycaine: nitracaine: Ester- Aminobenzoic orthocaine: oxetacaine (oxethazaine) oxybuprocaine: benoxinate, Novesine Paraethoxycaine [14 ...
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Since then, several synthetic local anesthetic drugs have been developed and put into clinical use, notably lidocaine in 1943, bupivacaine in 1957, and prilocaine in 1959. The invention of clinical use of local anaesthesia is credited to the Vienna School which included Sigmund Freud (1856-1939), Carl Koller (1857-1944) and Leopold Konigstein ...
Amide-linked local anesthetic agents, such as lidocaine and bupivacaine, can become "trapped" in their ionized forms on the fetal side of the placenta, so their net transfer across the placenta is increased. An ester-linked local anesthetic agent, such as 2-chloroprocaine, is rapidly metabolized, and placental transfer is limited.
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