Marcaine Spinal (bupivacaine hydrochloride 0.75% in dextrose injection) 2 mL x 10 Single-Dose Ampules

Marcaine Spinal (bupivacaine hydrochloride 0.75% in dextrose injection) is used for spinal anesthesia to provide prolonged pain relief during lower abdominal, pelvic, or lower limb surgeries. This local anesthetic works by blocking nerve impulses, leading to the temporary loss of sensation and motor function in the lower body. The inclusion of dextrose allows for a hyperbaric solution, which helps in precise control and distribution of the anesthetic effect in the spinal column, ensuring effective anesthesia for surgical procedures.

Marcaine Spinal (Bupivacaine Hydrochloride 0.75% in Dextrose Injection) is a local anesthetic solution designed for spinal anesthesia. It is primarily used for surgical procedures requiring lower abdominal, pelvic, and lower extremity anesthesia. The formulation includes dextrose, which helps ensure proper distribution in the cerebrospinal fluid. This product is supplied by Pfizer Injectables in single-dose ampules, with each ampule containing 2 mL of the solution, packaged in boxes of 10.

Details and Features

Active Ingredient: Bupivacaine Hydrochloride
Concentration: 0.75%
Dextrose Inclusion: Facilitates specific gravity and distribution in the spinal column
Volume: 2 mL per ampule
Packaging: 10 single-dose ampules per box
Usage: Intended for intrathecal (spinal) injection to induce regional anesthesia
Manufacturer: Pfizer Injectables

Mechanism of Action

Bupivacaine acts as a long-acting local anesthetic by blocking sodium ion channels in nerve fibers. This blockade inhibits the initiation and conduction of nerve impulses, producing loss of sensation or motor function at the targeted spinal regions. The presence of dextrose aids in the spread of the anesthetic in the cerebrospinal fluid by creating a hyperbaric solution, optimizing the anesthetic effects specific to the site of administration.

Warnings

• Cardiovascular Risks: May cause significant cardiovascular effects, including hypotension and bradycardia. Monitor vital signs closely after administration.
  
• Central Nervous System Effects: Serious CNS toxicity (e.g., seizures) can occur with systemic absorption or excessive dosages.
  
• Pregnancy: While used in obstetric anesthesia, careful consideration and dosing are necessary to minimize risks to the mother and fetus.
  
• Contraindications: Not suitable for patients with known hypersensitivity to bupivacaine or other amide-type anesthetics, as well as those with severe mental health disturbances, especially from hypercarbia or hypoxia.

Side Effects

Common Side Effects:

• Hypotension
  
• Nausea or vomiting
  
• Bradycardia
  
• Headache

Serious Side Effects:

• Cardiovascular: Severe hypotension, arrhythmias, or cardiac arrest
  
• CNS: Seizures or prolonged numbness beyond the target area
  
• Respiratory: Respiratory depression when anesthetic spreads too high (rare in properly managed doses)
  
• Allergic reactions: Although rare, include skin reactions or anaphylaxis

Administration and Monitoring

Marcaine Spinal should be administered by trained healthcare professionals experienced in spinal anesthesia techniques. Thorough patient evaluation and preparedness to manage potential adverse reactions are crucial. Continuous monitoring of blood pressure, heart rate, and respiratory status is necessary following administration. The dose should be carefully selected based on the patient's age, body mass, and overall health status, as well as the type and duration of the surgical procedure. Emergency equipment and drugs for resuscitation should be readily available prior to its use.