Bupivacaine

Anaesthesia

Anaesthesia · Amide local anaesthetic

Bupivacaine

Dose

Max 2 mg/kg (up to 150 mg) plain; heavy 0.5% for spinal anaesthesia.

Contraindications

  • Never use for IV regional anaesthesia (Bier's block)

Use

Long-acting infiltration, nerve and neuraxial blockade.

Monitoring

Aspirate before injection; monitor for LAST — perioral tingling, tinnitus, seizures, arrhythmia.

Side effects

  • Local anaesthetic systemic toxicity
  • Cardiac arrest resistant to resuscitation
  • Hypotension after spinal

Always confirm dose against your local formulary / BNF before prescribing.

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