Bupivacaine is a local anesthetic drug, most commonly available under the brand name of Marcaine.
amide
type
Longer duration of action
Mechanism of Action:
reversible blockade of impulse propagation
along nerve fibres by preventing the inward movement of sodium ions through the nerve
membrane.
Potency. Four times that of lidocaine, mepivacaine, and prilocaine.
Bupivacaine is on the World Health Organization’s List of Essential Medicines.
Metabolism. Metabolized in the liver by amidases.
Excretion. Via the kidney; 16% unchanged bupivacaine has
been recovered from human urine
Onset of action. Slower onset than other commonly used
local anesthetics (e.g., 6 to 10 minutes).
Route of elimination Only 6% of bupivacaine is excreted unchanged in the urine.
Half-life 2.7 hours in adults
Pregnancy classification. C.
Maximum recommended dose. The FDA MRD of bupivacaine is 90 mg. There is no recommended dose for
bupivacaine based on body weight in the United States
(Table 4.15).75,76 In Canada, the MRD is 2.0 mg/kg to a
maximum of 200 mg.77 For children older than 2 years,
in Canada the maximum dose of bupivacaine is based on
2.0 mg/kg (0.9 mg/lb).77
Brand names: Marcaine, Sensorcaine, Exparel, Kenalog, Posimir and others
Chemical formula: C18H28N2O
Contraindications
• Allergy or hypersensitivity to local anaesthetics of the amide type
In Australia, bupivacaine is on the National Podiatry Scheduled Medicines List for use by authorised Podiatrists.
Other local anaesthetics:
| Bupivacaine | Levobupivacaine | Tetracaine | Lidocaine | Prilocaine |
| Ropivacaine | Mepivacaine |
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