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Bupivacaine (Injection)

Used to numb an area of your body during surgery or other procedures, childbirth, or dental work. This medicine is a local anesthetic.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Brand names include
Bupivacaine Spinal, Bupivilog Kit, Dexlido-M, Dyural-40, Dyural-80, Dyural-LM, Ketorocaine-LM, MLK F1 Kit, MLK F2 Kit, MLK F3 Kit, MLK F4, MLK Procedure F1 Kit, Marbeta-25, Marbeta-L, Marcaine
Drug classes About this
Anesthetic, Local
Combinations including this drug

What works? Research summarized

Evidence reviews

Effectiveness and safety of ropivacaine and bupivacaine in spinal anesthesia: a meta-analysis

Bibliographic details: Liu ZH, Lv HW, Wang JK.  Effectiveness and safety of ropivacaine and bupivacaine in spinal anesthesia: a meta-analysis. Chinese Journal of Evidence-Based Medicine 2010; 10(5): 597-601

Effectiveness of caudal bupivacaine with neostigmine for postoperative pain management after hypospadias surgery in children: a systematic review

Bibliographic details: Lan Y P, Huang Z H, Zuo Y X.  Effectiveness of caudal bupivacaine with neostigmine for postoperative pain management after hypospadias surgery in children: a systematic review. Chinese Journal of Evidence-Based Medicine 2009; 9(6): 670-673

Analgesia after arthroscopic surgery: randomly controlled meta-analysis on intra-articular injection of bupivacaine placebo

Bibliographic details: Yang T, Gao SG, Luo W, Li YS, Xiong YL, Sun JP, Lei GH.  Analgesia after arthroscopic surgery: randomly controlled meta-analysis on intra-articular injection of bupivacaine placebo. Chinese Journal of Tissue Engineering Research 2013; 17(35): 6306-6313

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Summaries for consumers

Hyperbaric bupivacaine compared to isobaric bupivacaine for adequate spinal anaesthesia to complete caesarean section

This Cochrane systematic review summarized the best available evidence regarding the effectiveness and safety of the hyperbaric (denser than the spinal fluid) form of bupivacaine compared to the isobaric (equal density) form when used to provide spinal anaesthesia (injection of medications into the spinal column) for delivery of a baby by caesarean section. We searched the medical literature databases until March 2011 and included six randomized controlled studies involving 394 women. We found that hyperbaric bupivacaine was associated with less need for a switch to general anaesthesia and a more rapid onset of anaesthesia. However, due to the differences in the doses given, use of other drugs such as opioids, variation in regional anaesthesia techniques and small number of patients, we can only tentatively conclude that it is better than the isobaric form.

Temporary pain in the lower extremities following spinal anaesthesia with lidocaine compared to other local anaesthetics

Lidocaine is the drug of choice for inducing spinal anaesthesia in ambulatory surgery because of its rapid onset of action, intense nerve blockade, and short duration of action. The possible side effects of spinal anaesthesia in adults, which develop after recovery, are backache, post‐dural puncture headache, and transient neurologic symptoms that are characterized by slight to severe pain in the buttocks and legs. TNS symptoms develop within a few hours and up to 24 hours after anaesthesia. They last, in most cases, up to two days. The present review shows that lidocaine is more likely to cause transient neurologic symptoms than bupivacaine, prilocaine, and procaine. However, these drugs produce prolonged local anaesthetic effects and therefore are not desirable for ambulatory patients. It is possible that the reintroduction of 2‐chloroprocaine will solve this lack of a suitable intrathecal local anaesthetic; confirmatory studies are needed.

Interventions to reduce haemorrhage during myomectomy for treating fibroids

Some women have non‐cancerous growths of the uterus, called fibroids. In a third of cases the fibroids produce symptoms, such as vaginal bleeding, that warrant treatment. The surgical removal of the fibroids, called myomectomy, is one of the treatment options for fibroids. It can be accomplished by either laparotomy (through an incision into the abdomen) or laparoscopy (keyhole surgery). The procedure is associated with heavy bleeding. Many interventions have been used by doctors to reduce bleeding during an operation for removing fibroids but it is unclear whether or not the interventions are effective.

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