Senpivac-Plain (Epidural): The dose of any local anesthetic administered varies with the anesthetic procedure, the area to be anesthesized, the vascularity of the tissues, the number of neuronal segments to be blocked, the depth of anesthesia and degree of muscle relaxation required, the duration of anesthesia desired, individual tolerance, and the physical condition of the patient. The smallest dose and concentration required to produce the desired results should be administered. Dosages of Bupivacaine HCl should be reduced for young, elderly and debilitated patients and patients with cardiac and/or liver disease.
The rapid injection of a large volume of local anesthetic solution should be avoided and fractional(incremental) dose should be used when feasible.
In recommended doses bupivacaine produces complete sensory block, but the effect on motor function differs among the three concentrations.
0.25% when used for caudal, epidural or peripheral nerve block, produces incomplete motor block.
Should be used for operations in which muscle relaxation is not important, or when another means of providing muscle relaxation is used concurrently. Onset of action may be slower than with the 0.5% or 0.75% solutions.
0.5% provides motor blockade for caudal, epidural or nerve block but muscle relaxation may be inadequate for operations in which complete muscle relaxation is essential.
Maximum dosage limit must be individualized in each case after evaluating the size and physical status of the patient, as well as the usual rate of systemic absorption form a particular injection site.
Most experience to date is with single doses of bupivacaine up to 175 mg; more or less drug may be used depending on individualization of each case.
These doses may be repeated up to once every three hours. In clinical studies to date, total daily doses have been up to 400 mg. Until further experience is gained, this dose should not be exceeded in 24 hours. The duration of anesthetic effect may be prolonged by the addition of epinephrine. The dosages below have generally proved satisfactory and are recommended as a guide for use in the average adult. These dosages should be reduced for elderly or debilitated patients. Until further experience is gained, bupivacaine is not recommended for children younger than 12 years. Bupivacaine is contraindicated for obstetrical paracervical blocks and is not recommended for intravenous regional anesthesia (Bier's block).
Use in epidural Anesthesia: During epidural administration of Bupivacaine 0.5% and 0.75% solutions should be administered in incremental doses of 3 mL to 5 mL with sufficient time between doses to detect toxic manifestations of unintentional intravascular or intrathecal injection. In obstetrics, only the 0.5% concentrations should be exceeding 50 mg to 100 mg at any dosing interval are recommended. Use only the single dose ampoules and single-dose vials for caudal or epidural anesthesia.
Unused portions of solution should be discarded following initial use.
This product should be inspected visually for particulate matter and discoloration prior to administration. Solutions which are discolored or which contain particulate matter should not be administered.
Recommended Dose of Bupivacaine Hydrochloride: Epidural: 10-20 mL Moderate to complete; Caudal 15-30 mL Moderate to complete; Peripheral nerves 5 mL Moderate to complete.
Senpivac-Heavy (Spinal): The following doses are recommended: 0.40-0.05 mg/Kg for infants up to 5 Kg; 0.30-0.40 mg/Kg for children weighing between 5 and 15 Kg; 0.25 - 0.30 mg/Kg for children weighing more than 15 Kg.
The onset of anesthesia is slower than for Lidocaine and the duration is 60-20 minutes.
Unused portion of solution should be discarded following initial use.
Bupivacaine (Senpivac) Heavy should be inspected visually for discoloration and particulate matter prior to administration solution which are discolored or which contain particulate matter should not be administered.