Bupivacaine and Epinephrine (Bupivacaine Hydrochloride / Epinephrine Bitartrate Dental) - Summary

SUMMARY

Bupivacaine Hydrochloride is a local anesthetic.

Bupivacaine Hydrochloride is indicated for the production of local or regional anesthesia or analgesia for surgery, dental and oral surgery procedures, diagnostic and therapeutic procedures, and for obstetrical procedures. Only the 0.25% and 0.5% concentrations are indicated for obstetrical anesthesia. (See WARNINGS.) Experience with nonobstetrical surgical procedures in pregnant patients is not sufficient to recommend use of 0.75% concentration of Bupivacaine Hydrochloride in these patients. Bupivacaine Hydrochloride is not recommended for intravenous regional anesthesia (Bier Block). (See WARNINGS.) The routes of administration and indicated Bupivacaine Hydrochloride concentrations are:

local infiltration	0.25%
peripheral nerve block	0.25% and 0.5%
retrobulbar block	0.75%
sympathetic block	0.25%
lumbar epidural	0.25%, 0.5%, and 0.75% (0.75% not for obstetrical anesthesia)
caudal	0.25% and 0.5%
epidural test dose	0.5% with epinephrine 1:200,000

(See DOSAGE AND ADMINISTRATION for additional information.)
Standard textbooks should be consulted to determine the accepted procedures and techniques for the administration of Bupivacaine Hydrochloride.

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NEWS HIGHLIGHTS

Published Studies Related to Bupivacaine and Epinephrine (Bupivacaine / Epinephrine Dental)

Pre-emptive peritonsillar dexamethasone vs. levobupivacaine infiltration for relief of post-adenotonsillectomy pain in children: a controlled clinical study. [2014]
pediatric adenotonsillectomy patients... CONCLUSION: Peritonsillar dexamethasone infiltration was more effective than both

Bupivacaine extended-release liposome injection exhibits a favorable cardiac safety profile. [2012]
novel formulation of bupivacaine... CONCLUSIONS: A focused assessment of ECG data from a phase 2 study and cardiac

Triple-blind randomized clinical trial of time until sensory change using 1.5% mepivacaine with epinephrine, 0.5% bupivacaine, or an equal mixture of both for infraclavicular block. [2012]
by 20% or more versus 0.5% bupivacaine alone (bupivacaine)... CONCLUSIONS: Mixing 1.5% mepivacaine (with epinephrine) with 0.5% bupivacaine

Bupivacaine 0.5 % versus articaine 4 % for the removal of lower third molars. A crossover randomized controlled trial. [2011.12.06]
Objective: To compare the anesthetic action of 0.5% bupivacaine in relation to 4% articaine, both with 1:200,000 epinephrine, in the surgical removal of lower third molars. As a secondary objective hemodynamic changes using both anesthetics were analyzed...

Addition of epinephrine to epidural bupivacaine infusions following initiation of labor analgesia with epidural fentanyl. [2011.06]
STUDY OBJECTIVE: To evaluate the analgesic effects of the addition of epinephrine to a bupivacaine epidural infusion in early labor after a fentanyl bolus, following a lidocaine-epinephrine test dose... CONCLUSIONS: The administration of 0.625 mg/mL bupivacaine with epinephrine 5 mug/mL at 10 mL/hr, compared with plain 0.625 mg/mL bupivacaine at 10 mL/hr, provided a longer time to re-dose, decreased pain scores at two time intervals, and had no significant difference in duration of labor or side effects. Copyright (c) 2011 Elsevier Inc. All rights reserved.

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Clinical Trials Related to Bupivacaine and Epinephrine (Bupivacaine / Epinephrine Dental)

2% Lidocaine Plus 0.5% Bupivacaine Versus 0.5% Bupivacaine in Brachial Block for Creation of Arteriovenous (AV) Fistula [Recruiting]

Efficacy of Interscalene Brachial Plexus Block With Liposomal Bupivacaine for Arthroscopic Shoulder Surgery [Completed]
The purpose of this study is to compare the quality and duration of pain relief after shoulder surgery provided by a single injection of liposomal bupivacaine versus standard bupivacaine when administered as an interscalene brachial plexus block. It is hypothesized that the liposomal bupivacaine formulation will provide more effective pain relief than standard bupivacaine.

ED50 and ED95 of Intrathecal Bupivacaine With or Without Epinephrine for Total Knee Replacement Arthroplasty [Completed]
This prospective randomized double-blind dose-response study is aimed to investigate the ED50 and ED95 of intrathecal bupivacaine with or without epinephrine 100 mcg for total knee replacement arthroplasty.

Efficacy of Single Injection Femoral Nerve Block With Liposomal Bupivacaine for Total Knee Arthroplasty [Not yet recruiting]
The purpose of this study is to compare the quality and duration of pain relief after a total knee replacement provided by a single shot of standard bupivacaine versus a single shot of liposomal bupivacaine, at the site of the femoral nerve. It is hypothesized that the liposomal bupivacaine formulation will provide more effective pain relief than standard bupivacaine.

Analgesic Efficacy of Two Concentrations of Bupivacaine in Women in Labor [Completed]
Abstract. Epidural analgesia is the most safe and effective for the treatment of pain of childbirth method. Epidural Bupivacaine provided excellent analgesia for labor and remains the most widely used local anesthetic in obstetric anesthesia. Objective: To evaluate the analgesic efficacy of two concentrations of bupivacaine in women in labor. Methods: 114 patients were included in labor with term pregnancy. Were grouped randomly into two groups: patients who received bupivacaine 0. 125 % (Group A) and 0. 25% bupivacaine (group B). Patients in group A received 10 ml of 0. 125% bupivacaine bolus. The patients in group B received 10 ml. Bupivacaine 0. 25% bolus. Pain intensity according to VAS, blood pressure, heart rate, respiratory rate, degree of motor block was assessed using the Bromage scale at different periods of time. Results: Demographic characteristics and parity were compared, no statistically significant differences. By comparing the values of the VAS measure 0, 15, 30, 60 and 90 minutes into statistically significant differences in favor of the group with 0. 25% Bupivacaine with decreased pain perception after 30 minutes, p-value found 0. 02. No differences in arterial pressure, heart rate and respiratory rate were found between the two groups. Conclusion: The concentration of 0. 25% Bupivacaine has greater analgesic efficacy compared with 0. 125% bupivacaine.

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