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Dexcaine is a local anesthetic, with the main active ingredient being Bupivacaine hydrochloride. The following article provides you with some information on indications and notes when using Dexcaine.
1. What are the effects of Dexcaine?
Dexcaine contains the main active ingredient, Bupivacaine hydrochloride, which is prepared in the form of an injectable solution with a concentration of 20mg/tube of 4ml.
Bupivacaine is a local anesthetic of the amide group, with a long duration of action. Bupivacaine has a reversible blockade of nerve impulse conduction by reducing the permeability of nerve cell membranes to Na+ ions. Different injection solutions: 2.5mg/ml or 5mg/ml or 7.5mg/ml depending on the degree of need for more or less motor nervous system blockade. Bupivacaine is more cardiotoxic and neurotoxic than Lidocaine, Mepivacain or Prilocaine. Bupivacaine can cause intercostal neuralgia, pain relief lasts 7-14 hours after surgery, good epidural analgesia for 3-4 hours. Bupivacaine without epinephrine is used for spinal anesthesia in lower abdominal, obstetric, urological, and lower extremity surgeries.
2. Information on the main ingredients of Dexcaine - Bupivacaine hydrochloride
2.1 Indications of Bupivacain Indications to use Bupivacaine in the following cases:
Anesthesia for surgery and pain relief after surgery. Nerve and plexus blockade for surgery. Epidural anesthesia for surgery, prolonged postoperative pain relief by continuous or intermittent injection of local anesthetic through a catheter placed into the epidural space. An epidural for a cesarean section, or to help relieve pain during labor. Spinal anesthesia for lower abdomen, urology, lower extremities. 2.2 Contraindications Bupivacain Contraindications to the use of Bupivacaine in the following cases:
Patients with hypersensitivity reactions to local anesthetics of the amide group. Do not use for intravenous regional anesthesia or pericervical anesthesia in obstetrics. Do not use for spinal and epidural anesthesia in patients with severe hypotension in the case of cardiogenic shock or blood loss, patients taking anticoagulants or with coagulation disorders. Contraindicated to use bupivacaine 0.75% solution for epidural anesthesia in obstetrics due to inadvertent intravascular injection causing cardiac arrest in the mother. However, lower doses of bupivacaine can be used. 2.3 Caution when using Bupivacaine hydrochloride Bupivacaine is metabolised in the liver, so caution should be exercised when using the drug in patients with liver disease. Do not use preservative-containing solutions for epidural or sacral anesthesia; Seizures due to severe CNS toxicity can cause cardiac arrest, especially when unintentionally injected into a blood vessel. Bupivacaine is more cardiotoxic than other local anesthetics, and should be used with caution in patients with cardiovascular dysfunction. Acidosis or hypoxia may decrease a patient's tolerance to Bupivacaine and increase the risk and severity of Bupivacaine's toxic reactions. Pregnancy: Bupivacaine crosses the placenta. Pregnant women are more sensitive to bupivacaine, so it is necessary to reduce the concentration and dose of the drug when used in this population. In obstetrics, because bupivacaine is less likely to cause complications, it is often used to relieve pain during labor. Lactation: Bupivacaine enters breast milk, however, when the mother takes the drug at therapeutic levels, the drug passes into breast milk in small amounts and does not affect the baby. 2.4 Undesirable effects when using Bupivacaine hydrochloride Undesirable effects when using Bupivacaine hydrochloride patients may encounter with the following frequency:
Common: hypotension, bradycardia during spinal anesthesia. Rare: allergic reactions, anaphylaxis ; myocardial failure, systolic failure, loss of consciousness and convulsions due to overdose; neurological symptoms such as muscle weakness, paresthesia, and bladder dysfunction. Bupivacaine drug complications can be encountered in the unfortunate case of injection of the drug into the artery that brings blood to the brain when numbing the throat area such as: blockade of the stellate ganglia, tonsillectomy; or the case of injection of bupivacaine right into a small artery in the upper half of the body, causing the drug to go upstream to the brain. These cases all have a risk of causing central nervous system symptoms, seizures even when using the drug at low doses.
When using bupivacaine with a high total dose, there is also a risk of central nervous system complications, but cardiovascular adverse effects are more common. When Bupivacaine is accidentally injected intravenously, central nervous system symptoms may occur such as: "drunk state", agitation, nervousness, tinnitus, numbness of tongue and lips, slurred speech, dizziness, dizziness, feeling of tightness in the chest, local tremor. These symptoms are considered warning signs of toxicity, the injection should be stopped as soon as these symptoms appear. If continued use may lead to loss of consciousness, convulsions and total respiratory depression.
Cardiovascular complications when using Bupivacaine often occur slowly when overdose. However, rapid intravenous injection of a large dose of bupivacaine can result in large amounts of bupivacaine entering the coronary arteries, potentially causing severe myocardial failure leading to systolic failure.
When using bupivacaine for spinal anesthesia, or epidural can cause sympathetic blockade, leading to hypotension and bradycardia.
2.5 Drug Interactions Class I antiarrhythmic drugs such as tocainide: may increase the toxicity of bupivacaine. Patients receiving antiarrhythmic drugs with a local anesthetic effect, such as lidocaine, should use caution when taking bupivacaine because of the potential for increased toxicity. Dexcaine contains the main active ingredient Bupivacaine hydrochloride, which is a local anesthetic and is used as directed by your doctor. Patients need to comply to achieve the best treatment effect.
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