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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 ]
Local anesthetic injections are given in specific areas of the mouth, rather than the whole body. Although several different medications are available, the most commonly used local anesthetic to prevent pain in the area around a tooth is lidocaine (also called xylocaine or lignocaine). Lidocaine's half-life in the body is about 1.5–2 hours. [2]
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 was discovered in 1946 and went on sale in 1948. [12]
Many local anesthetics fall into two general chemical classes, amino esters (top) and amino amides (bottom). A local anesthetic (LA) is a medication that causes absence of all sensation (including pain) in a specific body part without loss of consciousness, [1] providing local anesthesia, as opposed to a general anesthetic, which eliminates all sensation in the entire body and causes ...
Bupivacaine (Marcaine) is the local anaesthetic most commonly used, although lidocaine , tetracaine, procaine, ropivacaine, levobupivicaine, prilocaine, or cinchocaine may also be used. Commonly opioids are added to improve the block and provide post-operative pain relief, examples include morphine , fentanyl , diamorphine , and buprenorphine .
A high dose of local anesthetic, typically lidocaine or prilocaine without adrenaline, [6] is slowly injected as distally as possible into the exsanguinated limb. The veins are filled with the anesthetic, with the anesthetic setting into local tissue after approximately 6–8 minutes, after which the surgery, reduction , or manipulation of the ...
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]
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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