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Bupivacaine, marketed under the brand name Marcaine among others, is a medication used to decrease sensation in a specific small area. [5] In nerve blocks , it is injected around a nerve that supplies the area, or into the spinal canal's epidural space . [ 5 ]
The search for a less toxic and less addictive substitute led to the development of the aminoester local anesthetics stovaine in 1903 and procaine in 1904. 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.
However, new data suggested both ropivacaine (1.2-1.8 mg/kg in 40ml) and levobupivacaine (40 ml of 0.125% solution) can be used, because they have less cardiovascular and central nervous system toxicity than racemic bupivacaine. [2]
The former anesthesiologist injected toxic levels of drugs into IV bags of saline at Baylor Scott & White Surgicare North Dallas and waited for them to be used in other doctors’ surgeries.
Levobupivacaine has become a more favourable alternative for regional anaesthesia than bupivacaine due to its reduced toxicity. A plethora of non-human studies have established levobupivacaine’s lower risk of cardiac and neurotoxic adverse effects.
Lipid emulsions are effective in treating experimental models of severe cardiotoxicity from intravenous overdose of local anaesthetic drugs such as bupivacaine. [1] [2] [3] [4]
“The FDA should act quickly to update this rule to prohibit healthy claims on foods that contain toxic chemicals,” Faber added. “A food filled with additives and dyes that have been banned ...
The wait time and isolation of blood flow from the region is important for avoiding an overdose of the anesthetic agent in the blood which can lead to hypotension, convulsions, arrhythmia, and death. Cardiotoxic local anesthetic agents like bupivacaine and etidocaine are strictly contraindicated. [1] [2] [7]