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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 ]
A mixture of 1 part 2% lidocaine with 3 parts 0.5% bupivacaine provides 0.5% lidocaine and 0.375% bupivacaine. This has the advantages of immediate anesthesia with lidocaine during injection to minimize injection pain while providing a longer duration of action with a lowered concentration of bupivacaine. [citation needed]
Levobupivacaine, the S(-)-enantiomer of bupivacaine has been developed as an alternative to the racemic mixture, as it has been shown to have a lower cardiotoxicity than bupivacaine. Under European Union advice, it can be applied for minor and major surgical anaesthesia , as well as (post-operative) pain management . [ 7 ]
When an effect is only required in one joint, a joint injection (or intra-articular injection) may be administered into the articular space surrounding the joint. These injections can range from a one-time dose of a steroid to help with pain and inflammation to complete replacement of the synovial fluid with a compound such as hyaluronic acid. [22]
The needle size, length and type should be selected based on the site, depth and patient's body habitus. 22–24G needles are sufficed for most injections. [1] As an example, ultrasound-guided hip joint injection [16] can be considered when symptoms persist despite initial treatment options such as activity modification, analgesia and physical ...
PO: oral • IV: intravenous injection • IM: intramuscular injection • SC: subcutaneous injection • SL: sublingual • TD: transdermal "Strength" is defined as analgesic potency relative to oral morphine. Tolerance, sensitization, cross-tolerance, metabolism, and hyperalgesia may be complex factors in some individuals.
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Interventional pain management or interventional pain medicine is a medical subspecialty defined by the National Uniforms Claims Committee (NUCC) as, " invasive interventions such as the discipline of medicine devoted to the diagnosis and treatment of pain related disorders principally with the application of interventional techniques in managing sub acute, chronic, persistent, and intractable ...
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