Marcaine

Marcaine is a local anesthetic with a long-lasting medicinal effect. Its effect is four times stronger than that of lidocaine.

Indications Marcaine

It is used in the following situations:

• for various injuries or arthroscopy, and also for infiltration pain relief (after surgeries);
• to assist during childbirth, and also during caesarean section procedures;
• when intercostal blockade occurs or when blockades occur in the area of large nerves;
• with retrobulbar anesthesia.

Use of the drug form of the substance Marcain Spinal: for the implementation of spinal anesthesia during operations in the urological area, as well as in the peritoneum or on the legs.

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Release form

It is released in the form of an injection medicinal solution (0.25% or 0.5%) in 20 ml vials.

Marcaine Spinal is a sterile form of water solution of the substance bupivacaine (volume 5 mg/ml). Due to the addition of sodium chloride, the solution becomes isotonic. The effect of the drug is quite strong and begins quite quickly. It demonstrates a fairly long-lasting effect.

Marcaine Spinal Heavy is also a 5 mg/ml bupivacaine solution, but it does not contain sodium chloride, instead it contains a dextrose solution, which gives the drug hyperbaric properties. It acts more intensely than Marcaine Spinal, but since it has a larger area of distribution, it has a lower concentration at the injection site, which reduces the duration of its effect.

Pharmacodynamics

The drug is a reversible blocker of impulses passing through nerve endings. It acts by inhibiting the processes of sodium passage through cell walls.

It has antihypertensive properties. During a peripheral nerve block, the duration of the anesthetic effect is 12 hours, during epidural anesthesia - within 2-5 hours, and during an intercostal block - within 7-13 hours.

The substance is produced in 2 concentrations: 5 or 2.5 mg/ml (the latter has a weaker active effect). In small doses it does not have a pronounced effect and is used during childbirth, as well as after surgical procedures.

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Pharmacokinetics

The rate of drug absorption depends on the dosage size and the method of administration of the solution. Peak values are observed during the treatment of intercostal blockades, and the lowest - in the case of injection of the drug subcutaneously into the abdominal area.

In the epidural area, the absorption of the substance occurs in 2 phases. The half-life in this case is 6 hours. With intravenous injection, this period lasts 2.5 hours. In a newborn child, the half-life is longer than in an adult - by about 7-8 hours.

Demonstrates a high level of protein synthesis. Completely undergoes metabolic processes within the body.

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Dosing and administration

Any anesthesia procedures can only be performed by a doctor, who also selects the dosage sizes. It is forbidden to prescribe more than 2 mg/kg of the drug. An adult portion is usually 30 ml.

During infiltration anesthesia, 5-30 ml of medication is administered.

In case of blockade in the area of the intercostal nerves, it is necessary to administer 2-3 ml of solution to each nerve.

When blocking the area of large nerves (when anesthetizing the sacral area or in the brachial plexus area), an injection of 15-30 ml of the drug is required.

Caudal anesthesia during labor - the dose is 6-10 ml of solution. When performing the anesthesia procedure, it is necessary to carefully monitor blood pressure indicators.

Use Marcaine during pregnancy

In the case of using Marcaine to perform a paracervical block in a pregnant woman, disturbances in the fetal heart rhythm may develop, which is why after the administration of the drug it is necessary to constantly monitor the heart rate and heart rate of the fetus.

Women in the 3rd trimester need to change the dosage of the drug in the form of Spinal Heavy.

The active ingredient of the drug passes into the mother's milk, but the likelihood of negative reactions in the infant due to this is extremely low.

Contraindications

Main contraindications:

• presence of hypersensitivity to the drug;
• childhood;
• decreased blood pressure.

For the Spinal Heavy form of the drug:

• pathologies in the central nervous system (bleeding, meningitis, brain tumors and poliomyelitis);
• diseases in the spine area that are in their active phase;
• spinal injury;
• problems with the coagulation system;
• presence of anemia;
• skin diseases at the puncture site;
• cardiogenic shock condition.

Both forms of the drug should be prescribed with caution to elderly people, and also if the patient has arrhythmia, AV block, cardiovascular diseases, multiple sclerosis, and hemiplegia.

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Side effects Marcaine

The use of the solution may provoke the appearance of the following side effects:

• decrease in blood pressure;
• development of bradycardia, heart rhythm disorder, and, at the same time, cardiac arrest;
• numbness of the tongue and the appearance of paresthesia;
• the occurrence of tinnitus or dizziness;
• the appearance of convulsions or tremors;
• injuries to the peripheral nerves;
• the appearance of anaphylaxis, skin manifestations, suppression of respiratory processes;
• problems with urination;
• double vision may begin;
• the appearance of pain in the back, and also a complete spinal block (when using the LS form - Spinal Heavy).

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Overdose

Poisoning manifests itself in the form of toxic manifestations from the cardiovascular system and central nervous system. Similar reactions also occur in the case of accidental intravascular injection. Overdose symptoms include dizziness with paresthesia, tinnitus, weakened vision, and numbness of the tongue. Then convulsions with tremor, an epileptic seizure, and loss of consciousness occur. The victim's condition will improve if the administration of the solution is stopped. Signs of disturbances in the cardiovascular system appear later and occur in the form of blockades, decreased blood pressure, and bradycardia.

It is necessary to support the respiratory system and blood flow, provide oxygenation or perform artificial respiration if the situation is severe. If the victim is having convulsions, sodium thiopental is administered.

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Interactions with other drugs

When combined with antiarrhythmic drugs and other anesthetics (for example, with mexiletine or lidocaine), the likelihood of developing a toxic effect increases.

Combination with halothane anesthetic potentiates the likelihood of arrhythmia.

MAOIs used in combination with Marcaine increase the risk of increased blood pressure.

It is prohibited to mix the medicinal solution with other medications.

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Storage conditions

Marcaine is kept in standard conditions for medicines. Temperature marks are within 15-25°C.

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Special instructions

Reviews

Marcaine contains the substance bupivacaine, which is a powerful anesthetic, exceeding the effect of novocaine by 16 times. The anesthetic effect begins later (in comparison with lidocaine), but is longer lasting - taking into account the dosage size and the method of administration, it can last within 3-12 hours. The muscle relaxation rate of this product, according to reviews, is higher than that of the lidocaine component.

Spinal forms of the drug demonstrate higher safety and effectiveness as an analgesic. The main advantage of the drug is the lack of need for combination with analgesic drugs, as well as additional prolongation. In addition, there is no need to reduce the dose due to possible toxic properties of the drug. These forms of the drug are used in any operations in the gynecological field, amputations, cesarean sections, hernias, and adenomectomies. Medical practice shows that the hyperbaric type of medication is more optimal than the isobaric one, because it is easier to manage. But at the same time, patients note that negative effects often develop when performing spinal anesthesia.

Usually, when using hyperbaric anesthesia, the development of bradycardia occurs already at the postoperative stage, but in the case of using Marcain Spinal, this effect is observed much earlier - even at the stage of the operation.

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Shelf life

Marcaine is allowed to be used for 3 years from the date of release of the drug.

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