Doctor insights on:
Local anesthetic: Long acting local anesthetic with generic name bupivacaine, belonging to the class of amide local anesthetics, as opposed to some other "caines" that have an esteric bond in their molecule (procaine (Novocain), tetracaine). It is used by prescription for nerve blocks, labor epidurals, local infiltration to relive pain by temporarily numbing the nerves responsible for the sensation from the area ...Read more
Multiple ways: Bupivacaine is a long-acting local anesthetic. As such, it can be injected around a site to be operated on (local infiltration), around a nerve or group of nerves supplying an area of the body (a nerve block), into the sac of fluid bathing the spinal cord (spinal block) or outside that sac (epidural block), essentially numbing up a larger area (usually the lower half of the body) ...Read more
No: Lidocaine and bupivacaine are in the same family of local anesthetics as they are both amino amides but there are difference in onset of action and duration of action and toxicities. Lido is a shorter acting agent whereas bupivacaine is a longer acting agent. ...Read more
Therapeutic profile: The anti and proarrhythmic effects of bupivacaine have been studied (pubmed id 9605693). Similarly, the local anesthetic properties of class I arrhythmics (function through sodium channel blockade like local anesthetics) have been compared with Lidocaine and bupivacaine. Toxicity of bupivacaine must be understood in the context of complex cardiac effects. See pmid3408033 and tinyurl. Com/bjdzske. ...Read more
Same as any allergy: If there are hives/body or throat swelling/local rash / rapid heart beat, shortness of breath, low blood pressure after injection it MAY indicate allergy. BUT almost every time a patient tells me that we find the reaction was actually related to something mixed with the Bupivacaine (like epinephrine etc) which can cause similar symptoms as a normal side effect hence important to clarify with doc. ...Read more
How many bupivacaine injections in the right scaplothoracic region are safe at one time? Is 8 ok? Are flu-like symptoms cause for concern?
Depends: You need to discuss the risks/benefits of multiple injections with your doctor. Depending on your condition, doing several injections, if beneficial, may be acceptable despite slightly higher risk. That decision needs to be made mutually in the clinic before the injections. ...Read more
DiagnosticSUPINE celiac plexus block yesterday, only received bupivacaine. Painfree x10 hrs. Today, Bad new type of upper abd pain. Tender in mid & upper abd Doubled up at times. No fevers.
There are none...: Even the strongest opiates only "take the edge off" for people in chronic pain. Meds are only one part of dealing with the pain. A useful tool, but pain is so necessary for survival that we are not "allowed" to monkey with it much. In acute pain, the transition from miserable to less miserable can be great. In chronic pain, it's just part of the plan. ...Read more
Sometimes: Sometimes they are. For the most part, expired drugs simply lose potency once past their expiration date. There are, however, some drugs that actually become harmful if taken after they expire. As such, it is best to throw out any medications you have after a year. ...Read more
ASPRIN: Actually no one has decided on 'safest'. Asprin has been around since before you were born and unless you take too much (yes, too much of anything isn't good) most people are okay with it. If the pain it too severe for asprin you need to know what causes it. Good diagnosis is called for. See the dr. ...Read more
Applies to skin: Topical just refers to how a medication is applied. In this case to the skin and is meant to treat local skin problems. Some meds are applied to the skin but are meant to be absorbed into the body in which case we use the term "transdermal" since it is meant to pass through the skin to affect the whole body. ...Read more