Markain spinal heavy ampoules 0.5% 4ml №5

Composition

Active substance: bupivacaine hydrochloride monohydrate for injection 5.28 mg.

Excipients: dextrose monohydrate, sodium hydroxide 2M for injection to bring the pH to 4.0-6.0, water for injection.

Packing

5 pieces

Mechanism of action

MARKAIN SPINAL KHEVI - local anesthetic of amide type. With intrathecal administration, the effect is rapid, and its duration varies from moderate to prolonged. The duration of the effect depends on the dose.

The solution of the drug is hyperbaric and its distribution in the subarachnoid space is affected by gravity. A small volume of distribution in the intrathecal space leads to a lower average concentration and a decrease in the duration of the effect of the drug as compared with the isobaric solution. Solutions that do not contain dextrose give a less predictable level of blockade. The relative density at a temperature of 20 ° C is 1.026 (which corresponds to 1.021 at a temperature of 37 ° C). The pH of the solution is 4.0-6.0.

Bupivacaine reversibly inhibits the conduction of impulses along the nerve fiber by blocking the passage of sodium ions through the cell membrane.

Indications and usage

Intrathecal anesthesia (subarachnoid, spinal) with surgical and obstetric interventions:
On the lower sections of the abdominal cavity (including caesarean section).
On the lower limbs (including the hip joint).
In urological operations lasting 1.5-3 hours

Contraindications

Hypersensitivity to any of the components of the drug or to other local anesthetics amide type.

Pregnancy and Breastfeeding

Pregnancy: was used in a large number of pregnant women and women of childbearing age. No effect of the drug on reproductive function or an increase in the incidence of malformations was noted. In patients in late pregnancy it is recommended to use reduced doses of the drug.

Lactation: penetrates into breast milk in quantities that do not pose a danger to the baby.

Dosage and administration

When conducting epidural anesthesia, it is necessary to conduct a test dose of 3-5 ml. During the test dose for 5 minutes, it is necessary to maintain verbal contact with the patient and to regularly determine the heart rate. Aspiration should be carried out before the introduction of the main dose, which should be administered slowly, 25-50 mg / min under constant supervision. With the appearance of minimal toxic effects, further introduction is stopped. When used in adults for the blockade of the trigeminal nerve, 1–5 ml (2.5–12.5 mg) should be injected, 10–20 ml (25–50 mg) for the blockade of the stellate ganglion, for long-term epidural anesthesia — 20 ml (50 mg) first, then 6–16 ml (15–40 mg) every 4–6 hours; for intercostal blockade, 2–3 ml (10–15 mg) for one nerve (10 nerves in total), for large blockades (sacral, brachial, etc. - 15-30 ml (75-150 mg).For anesthesia in obstetrics, they are used in the following initial doses (they can be repeated every 2-3 hours): for epidural and caudal anesthesia (for vaginal delivery and vacuum extraction) - 6-10 ml (15-25 mg); for epidural blockade with caesarean section - 15-30 ml (75-150 mg); 5-10 ml (12.5-25 mg) for double-sided pudandal blockade. The maximum recommended doses of the drug during the 4 h period are 2 mg / kg (up to 150 mg). The maximum recommended dose is 400 mg / day. The total dose should be calculated based on the physical status of the patient. The concentration of the solution used depends on the type of anesthesia: infiltration - 0.25%, conductive - 0.25-0.5%, retrobulbar - 0.75%, sympathetic blockade - 0.25%, epidural lumbar anesthesia - 0.25-0.75%, caudal - 0.25-0.5%, conductive - 0.5 % (with the addition of epinephrine at the rate of 1: 200000).

Storage conditions

Store at a temperature of 2-25 ° C. Do not freeze.