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.
Solutions containing preservatives should not be used for caudal or epidural blocks.
- Epidural (Adults and Children >12 yr): 1020 mL of 0.25% (partial to moderate block), 0.5% (moderate to complete block), or 0.75% (complete block) solution. Administer in increments of 35 mL allowing sufficient time to detect toxic signs/symptoms of inadvertent IV or IT administration. A test dose of 23 mL of 0.5% with epinephrine solution is recommended prior to epidural blocks.
- Caudal block (Adults and Children >12 yr): 1530 mL of 0.25% or 0.5% solution. A test dose of 23 mL of 0.5% with epinephrine solution is recommended prior to caudal blocks.
- Peripheral nerve block (Adults and Children >12 yr): 5 mL of 0.25% or 0.5% solution (maximum dose = 400 mg).
- Sympathetic nerve block (Adults and Children >12 yr): 2050 mL of 0.25% solution.
- Dental block (Adults and Children >12 yr): 1.83.6 mL per site of 0.5% with epinephrine solution.
- Local infiltration (Adults and Children >12 yr): 0.25% solution infiltrated locally (maximum dose = 175 mg).
- Implant (Adults): 300 mg (three 100mg implants) as single dose.
Marcaine, Sensorcaine, Xaracoll
Therapeutic Classification: epidural local anesthetics, anesthetics (topical/local)
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: 1.55 hr (after epidural use); 19 hr (implant).
(analgesia)
Duration of anesthetic block.