Bupivacaine Hydrochloride in Dextrose Injection

What is Bupivacaine Hydrochloride in Dextrose Injection?
Bupivacaine Hydrochloride in Dextrose is a sterile, "hyperbaric" solution specifically designed for spinal anesthesia. The addition of Dextrose increases the density (specific gravity) of the medication, making it heavier than human cerebrospinal fluid (CSF). This characteristic allow the anesthesiologist to use gravity to control the spread of the anesthetic within the spinal canal, ensuring the "block" remains at the desired level for the duration of the surgery.
Uses of Bupivacaine Hydrochloride in Dextrose Injection
Obstetric Anesthesia: The gold standard for Cesarean sections (C-sections) due to its rapid onset and reliable, dense block.
Lower Abdominal Surgery: Ideal for procedures such as hernia repairs, appendectomies, and hysterectomies.
Urological Procedures: Used for transurethral resections (TURP) and other bladder or prostate surgeries.
Orthopedic Surgery: Effective for hip and knee replacements or lower limb fracture repairs.
Vascular Surgery: Regional anesthesia for surgeries involving the lower extremities.
How Does Bupivacaine Hydrochloride in Dextrose Work?
As a potent amide-type local anesthetic, Bupivacaine blocks the conduction of nerve impulses by inhibiting voltage-gated sodium channels on the nerve cell membrane. This prevents the generation of the electrical signals that communicate pain to the brain. Because this formulation is hyperbaric (heavier than CSF), it settles in the dependent (lowest) parts of the spinal curvature based on how the patient is positioned. This provides predictable, long-lasting regional anesthesia and profound muscle relaxation.
FAQs on Bupivacaine Hydrochloride + Dextrose Injection
1. Why is Dextrose added to Bupivacaine for spinal use? Dextrose is used as a "weighting agent." By making the solution heavier than spinal fluid, it allows the anesthesiologist to "steer" the numbing effect. If the patient is tilted slightly head-up, the heavy solution stays in the lower spine, preventing it from rising too high and affecting the patient's breathing.
2. What is the duration of the anesthetic effect? Bupivacaine is a long-acting anesthetic. For spinal procedures, it typically provides surgical anesthesia for 2 to 3 hours, with sensory numbness and muscle relaxation gradually wearing off over 4 to 6 hours.
3. What precautions are necessary during administration? Since a spinal block causes rapid vasodilation in the lower body, hypotension (low blood pressure) is a common side effect. Continuous monitoring of blood pressure, heart rate, and oxygen saturation is mandatory. Additionally, the drug must be administered using a strict aseptic technique to prevent spinal infections.
Therapeutic Category
Anesthetics (Regional/Spinal Anesthetic - Amide type)
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