📋 Indications & Clinical Dosage
*Surgical anaesthesia, lumbar epidural block:*
BY REGIONAL ADMINISTRATION: Adult: 75-150 mg, dose administered using a 5 mg/ml (0.5%) solution.
*Surgical anaesthesia, field block:*
BY REGIONAL ADMINISTRATION: Adult: Up to 150 mg, dose administered using a 2.5 mg/ml (0.25%) or 5 mg/ml (0.5%) solution.
*Surgical anaesthesia, thoracic epidural block:*
BY THORACIC EPIDURAL: Adult: 12.5-50 mg, dose administered using a 2.5 mg/ml (0.25%) or 5 mg/ml (0.5%) solution
Children (up to 10 yr): using 0.25% solution, up to lower thoracic (T10) 0.3-0.4 mu kg, up to mid-thoracic (T6) 0.4-0.8 ml/kg.
*Surgical anaesthesia, caudal epidural block:*
BY REGIONAL ADMINISTRATION: Adult: 50-150 mg, dose administered using a 2.5 mg/ml (0.25%) or 5 mg/ml (0.5%) solution.
*Surgical anaesthesia, major nerve block:*
BY REGIONAL ADMINISTRATION: Adult: 50-175 mg, dose administered using 5 mg/ml (0.5%) solution.
*Acute pain, intra-articular block:*
BY INTRA-ARTICULAR INJ: Adult: Up to 100 mg, dose administered using a 2.5 mg/ml (0.25%) solution; when co-administered with bupivacaine by another route, total max. 150mg.
*Acute pain, thoracic epidural block:*
BY CONTINUOUS EPIDURAL INF: Adult: 6.3-18.8 mg/hour, dose administered using a 1.25 mg/ml (0.125%) or 2.5 mg/ml (0.25%) solution; max. 400 mg per day.
*Acute pain, labour:*
BY CONTINUOUS EPIDURAL INF: Adult: 6.25-12.5 mg/hour, dose administered using a 1.25 mg/ml (0.125%) solution; max. 400 mg per day.
*Acute pain, lumbar epidural block:*
BY LUMBAR EPIDURAL: Adult: Initially 15-37.5 mg, then 15-37.5 mg, repeated when required at intervals of at least 30 minutes, dose administered by intermittent injection using a 2.5 mg/ml (0.25%) solution, alternatively (by continuous epidural INF) 12.5-18.8 mg/hour, dose administered using a 1.25 mg/ml (0.125%) or 2.5 mg/ml (0.25%) solution; max. 400 mg per day.
*Acute pain, field block:*
BY REGIONAL ADMINISTRATION: Adult: Up to 150 mg, dose administered using a 2.5 mg/ml (0.25%) solution.
💊 Mode of Administration
Administered by infiltration or by epidural, spinal, or peripheral or sympathetic nerve block as a single injection or repeat injections. Injection should be made slowly. Product containing preservatives should not be used for epidural or caudal block.
⛔ Contraindications
Application to the middle ear (can cause ototoxicity), avoid injection into infected tissues or inflamed tissues and damaged skin, complete heart block. Children below 12 years not recommended,
⚠️ Precautions & Warnings
Cardiovascular disease, cerebral atheroma, debilitated patients and elderly (consider dose reduction), epilepsy, hypertension, hypotension, hypovolaemia, impaired cardiac conduction, impaired respiratory function, myasthenia gravis, myocardial depression may be more severe and more resistant to treatment, shock, hepatic impairment. To avoid excessive dosage in obese patients, dose should be calculated on the basis of ideal body-weight.
⚠️ Adverse Reactions / Side Effects
Arrhythmias, blurred vision, cardiac arrest, convulsions, dizziness, drowsiness, feeling of inebriation, headache, lightheadedness, muscle twitching, myocardial depression (resulting in hypotension and bradycardia), nausea, numbness of the tongue and perioral region, paraesthesia (including sensations of hot and cold), peripheral vasodilatation (resulting in hypotension and bradycardia), restlessness, tinnitus, transient excitation (followed by depression with drowsiness, respiratory failure, unconsciousness, and coma), tremors, vomiting
🧪 Compatibility & Storage Stability
Stability & Storage: Stored at controlled room temperature. Freezing should be avoided.