section name header

Pronunciation

byoo-PI-vi-kane

Classifications

Therapeutic Classification: epidural local anesthetics, anesthetics (topical/local)

Indications

REMS


Implant

Action

  • Local anesthetics inhibit initiation and conduction of sensory nerve impulses by altering the influx of sodium and efflux of potassium in neurons, slowing or stopping pain transmission.
Therapeutic effects:
  • Decreased pain or induction of anesthesia; low doses have minimal effect on sensory or motor function; higher doses may produce complete motor blockade.

Pharmacokinetics

Absorption: Systemic absorption follows epidural administration, but amount absorbed depends on dose.

Distribution: If systemic absorption occurs, this agent is widely distributed and crosses the placenta.

Metabolism/Excretion: Small amounts that may reach systemic circulation are mostly metabolized by the liver; 6% excreted unchanged in the urine.

Half-Life: 1.5—5 hr (after epidural use); 19 hr (implant).

Time/Action Profile

(analgesia)

ROUTEONSETPEAKDURATION
Epidural10–30 minUnknown2–8 hr
ImplantUnknownUnknownUnknown



Duration of anesthetic block.



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: arrhythmias, bradycardia, CARDIOVASCULAR COLLAPSE, hypotension

Derm: pruritus

EENT: blurred vision, tinnitus

F and E: metabolic acidosis

GI: nausea, vomiting

GU: urinary retention

Hemat: methemoglobinemia

Local: incision site swelling/pain (implant)

Neuro: anxiety, circumoral tingling/numbness, dizziness, dysgeusia, headache, irritability, SEIZURES, tremor

Misc: fever, allergic reactions

Interactions

Drug-drug:

Route/Dosage

Availability

(Generic available)

Assessment

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Marcaine, Sensorcaine, Xaracoll