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Spino
Incepta Pharmaceuticals Ltd.
Generic: Bupivacaine + Dextrose
Medicine Overview of Spino (5mg+80mg)/ml Injection
বাংলা
English
Indication
Intrathecal anesthesia, Spinal anesthesia, Epidural anesthesia, Subarachnoid anesthesia
Adult Dose
Adult: Inj Percutaneous infiltration anesth For prolonged action: 9 mg w/ adrenaline (1 in 200,000), may repeat 2-10 mins later if needed. Max: 90 mg per dental sitting. Surgical anaesthesia Peripheral nerve block 12.5 mg (as 0.25% soln) or 25 mg (as 0.5% soln) . Max: 150 mg/dose. Sympathetic nerve block As 0.25% soln: 50-125 mg. Retrobulbar block As 0.75% soln: 15-30 mg. Caudal block In surgery: 37.5-75 mg (as 0.25% soln) or 75-150 mg (as 0.5% soln). Lumbar epidural block In surgery: 25-50 mg (as 0.25% soln) and 50-100 mg (as 0.5% soln). Spinal block: 0.5% soln: 10-20 mg...
... Show moreChild Dose
12 years
Local Anesthesia: Infiltration 0.25% infiltrated locally: 175 mg maximum
Caudal Block: 15-30 mL of 0.25% or 0.5% (preservative free)
Epidural Block Other Than Caudal Block: 10-20 mL of 0.25% or 0.5%; administer in 3-5 mL increments allowing sufficient time to detect toxic manifestations of inadvertent IV or IT administration (preservative free); for surgical procedures requiring high degree of muscle relaxation and prolonged effects administer10-20 mL of 0.75%; not to be used in obstetrical cases
Peripheral or Sympathetic Nerve Block
>12 years
Peripheral Nerve Block: 5 mL of 0.25-0.5%; 400 mg/day maximum
Sympathetic Nerve Block: 20-50 mL of 0.25%
Contraindication
Hypersensitivity to local anaesthetics of amide type. IV regional anaesthesia; paracervical block in obstetrics; spinal anaesthesia <18 yr. Lactation. Solutions containing preservatives for caudal or epidural block.
Mode 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 w/ resultant blockade of conduction. Dextrose is a monosaccharide that is used as a source of calories and water for hydration. It helps to reduce loss of body protein and nitrogen. It also promotes glycogen deposition in the liver.
Precaution
Hepatic disease; CV disease; children <12 yr; pregnancy. Elderly and debilitated patients.
Lactation: excretion in milk unknown/not recommended
Side Effect
CNS excitation may be followed by depression. Hypotension, bradycardia, arrhythmias and cardiac arrest; methaemoglobinaemia; seizures, restlessness, dizziness. Hypersensitivity. Prolonged block, Edema, Headache, Hypotension, Hypoventilation, Nausea, Nervousness, Palpitation, Respiratory arrest, Tachycardia, Tinnitus, Tremors, Vomiting.
Potentially Fatal: Cardiac and sudden respiratory arrest.
Pregnancy Category Note
Pregnancy Category: C
Lactation: excretion in milk unknown/not recommended
Interaction
Additive systemic toxic effect w/ other local anaesth or agents structurally related to amide-type local anaesth (e.g. lidocaine and mexiletine). Increased risk of myocardial depression w/ antiarrhythmics. Enhanced adverse effects w/ hyaluronidase. Decreased clearance resulting to increased plasma concentrations w/ cimetidine and ranitidine. Increased risk of adverse effects w/ beta-blockers and Ca channel blockers.
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