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Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
There are no controlled studies in breastfeeding women, however the risk of untoward effects to a breastfed infant is possible; or, controlled studies show only minimal non-threatening adverse effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant.
Typical usage: Percutaneous infiltration anaesthesia, Peripheral nerve block, Sympathetic nerve block, Retrobulbar block, Caudal block and Lumbar epidural block.
Side Effects: CNS excitation may be followed by depression. Hypotension, bradycardia, arrhythmias and cardiac arrest; methaemoglobinaemia; seizures, restlessness, dizziness. Hypersensitivity. Prolonged block, Cardiac and sudden respiratory arrest.
Drug Interaction: Decreased duration with hyaluronidase. Decreased clearance with cimetidine and ranitidine. Potentiates lidocaine and mepivacaine. Allergic-type reactions with formulations containing sodium metabisulfite. May potentiate systemic toxicity of other local amide anaesthetics. Increased risk of myocardial depression with antiarrhythmics.
Mechanism Of Action: Bupivacaine blocks both the initiation and conduction of nerve impulses reducing the permeability of neuronal membranes to Na ions resulting in inhibition of depolarization with resultant blockade of conduct.