Bupivacaine Hydrochloride

Adults: Each 30 ml contains 150 mg Bupivacaine Hydrochloride (anhydrous) USP. The dose of any local anaesthetic depends on the anaesthetic procedure, the area to be anaesthetized, the vascularity of the tissues and the number of neuronal segments to be blocked. At the recommended doses, Bupivacaine produces complete sensory block, but the effect on motor function differs among the three concentrations. The 0.25% strength, when used for caudal, epidural or peripheral nerve block, produces incomplete motor block. It should be used for operations where muscle relaxation is not important, or when another means of muscle relaxation is used at the same time. Its onset of action may be slower than with the 0.5% or 0.75% solutions. The 0.5% strength provides motor blockade for caudal, epidural or nerve block, but muscle relaxation may be inadequate for operations in which complete muscle relaxation is essential. The maximum dose must be worked out for each patient after looking at the size and physical status of the patient, and the usual rate of systemic absorption from the particular injection site. Most experience to date is with single doses of Bupivacaine up to 175 mg, and these doses may be repeated up to once every three hours. In clinical studies so far, total daily doses up to 400 mg have been reported. Until more experience is gained, this dose should not be exceeded in 24 hours. The following doses have generally proved satisfactory and are recommended as a guide for the average adult. They should be reduced for young, elderly or debilitated patients. Local infiltration, 0.25%: up to max (mg). Epidural, 0.5%: 50 to 100 mg. Epidural, 0.25%: 25 to 50 mg. Caudal, 0.5%: 75 to 150 mg. Caudal, 0.25%: 37.5 to 75 mg. Peripheral nerves, 0.5%: 25 mg to max. Peripheral nerves, 0.25%: 12.5 mg to max. Sympathetic, 0.25%: 50 to 125 mg.