Spinal marcaine
 Marcaine - Local anesthetics.

Pharmacological action

Active substance marcaine - bupivacaine, anesthetic of amide type with long duration of action.

Marcaine causes blockade (reversible) nerve fibers and prevents conduction of impulses through inhibition of the passage of sodium ions through nerve cells.

Use marcaine mainly for long-term epidural (agent is administered through the spine) analgesia.

According to the instructions marcaine in small doses has a less pronounced effect, it can be used for anesthesia after surgery, during labor and delivery.

Marcaine spinal acts on the same type, it is used for subarachnoid anesthesia (to be administered in the area below the spinal cord).

Product form

Marcaine and spinal marcaine produced in injectable solutions.


The instructions marcaine indicated that the drug is used for infiltration anesthesia when necessary prolonged anesthesia patient.

The drug is indicated for continuous epidural anesthesia and the wires when the use of strong muscle relaxant, or combinations of adrenaline impossible. Its effectiveness in obstetric practice.

Marcaine spinal used for spinal anesthesia in operations (as in prolonged operations in the legs), and gynecological procedures.

Instructions for use marcaine

Marcaine should be administered with caution. Before the first epidural anesthesia do the test injection - 3-5ml marcaine with adrenaline, and for five minutes control the frequency of heart beats, maintain verbal contact with the patient. It is desirable to conduct the test in a room where there is equipment for resuscitation.

Epidural anesthesia is performed at a speed of 25-50mg / min and deposit funds in stages. The dosage of bupivacaine determined strictly individually.

To carry out infiltration anesthesia is administered 5-30ml marcaine (25-150mg bupivacaine).

To carry out the intercostal nerve block for instructions marcaine administered at 2-3ml (bupivacaine dose contains 10-15mg) per nerve.

During the large nerve blockade (epidural anesthesia, sacral, brachial plexus) is administered 6-10ml (30-50mg of the active substance) of the drug. If portability marcaine good, you can enter it again in two, three hours.

For epidural blockade (also for cesarean section) is administered 15-30ml means (75-150 active substance).

Bupivacaine dosage should be reduced when it is shown the combination with opioids.

Acceptable Dosage - 2 mg per kg of body weight, the adult maximum dose - 30 ml (150 mg bupivacaine), which is administered over four hours.

Permissible daily dose - 400 mg of bupivacaine.

Marcaine spinal urological operations, operations on the perineum, legs administered at 2-3ml (10-15mg) to a patient in a horizontal position. The action starts after 5-8min anesthesia and lasts two to three hours.


For operations in the abdomen, on the hip marcaine spinal administered at 3-4ml (15-20mg). Proceed through 5-8min anesthesia begins and lasts the next 3-4ch.

The drug can be administered and children. Newborns, infants to achieve the level of blockade in adults requires an increased dose of spinal marcaine since they have a large volume of the cerebrospinal fluid. The calculation is carried out based on the weight of the child. Babies weighing up to five kg administered 0, 4-0, 5 mg / kg; children weighing 5-15kg - 0, 3-0, 4 mg / kg; children weighing 15-40kg administered 0, 25-0, 3MK kg.

side effects

Marcaine can cause hypertension or hypotension, cardiac arrest, bradycardia, cardiac arrhythmias, headache, paresthesia, numbness of the tongue, tinnitus, hyperacusis (fear of loud noises), dizziness, blurred vision, tremors, loss of consciousness, double vision, arachnoiditis (inflammation of the spinal membranes, brain).

Also, due to the drug can develop neuropathy, peripheral nerve damage, allergies, nausea, respiratory depression, vomiting, impaired urination, muscle weakness, paralysis, spinal block, back pain, paraplegia.

Contraindications marcaine

Marcaine of instructions can not be used for epidural anesthesia for those who suffer severe hypotension (including hypovolemic, cardiogenic shock).

Also, do not use the tool in pediatrics, for intravenous regional anesthesia (Bier blockade on), diseases of the nervous system, intracranial bleeding, tuberculosis and metastases in the spine, septicemia, decompensated heart disease, pernicious anemia with spinal symptoms, ascites expressed, massive pleural effusion , arthritis, spondylitis and other diseases of the spinal column, in severe intra-abdominal pressure, abdominal mass, pustular skin lesions, severe hypotension, with the pathologies bleeding during treatment with anticoagulants.

Marcaine spinal not indicated in patients with heart failure, hepatic, hypotension, hyperthyroidism, children under 12 liters. Not excluded contra marcaine.

Precautions were anesthetized marcaine, marcaine spinal lactating and pregnant women.