Bupivacaine hydrochloride is a local anesthetic.
MARCAINE is indicated for the production of local or regional anesthesia or analgesia for surgery, dental and oral surgery procedures, diagnostic and therapeutic procedures, and for obstetrical procedures. Only the 0.25% and 0.5% concentrations are indicated for obstetrical anesthesia.
Experience with nonobstetrical surgical procedures in pregnant patients is not sufficient to recommend use of 0.75% concentration of MARCAINE in these patients.
MARCAINE is not recommended for intravenous regional anesthesia (Bier Block). See WARNINGS.
The routes of administration and indicated MARCAINE concentrations are:
(See DOSAGE AND ADMINISTRATION for additional information.)
|Peripheral nerve block
|0.25% and 0.5%
|0.25%, 0.5%, and 0.75%
(0.75% not for obstetrical anesthesia)
|0.25% and 0.5%
|Epidural test dose
|0.5% with epinephrine 1:200,000
|0.5% with epinephrine 1:200,000
Standard textbooks should be consulted to determine the accepted procedures and techniques for the administration of MARCAINE.
Media Articles Related to Marcaine (Bupivacaine)
Liposomal Bupivacaine Helpful in Total Knee Arthroplasty
Source: Medscape Orthopaedics Headlines [2016.10.18]
Local infiltration of liposomal bupivacaine in patients undergoing total knee arthroplasty (TKA) curbed use of opioids and antiemetics and appeared to be both beneficial and cost effective in a recent study.
Reuters Health Information
The Evaluation of Clinical Superiority in Anesthesia Trials
Source: Medscape Anesthesiology Headlines [2016.10.19]
The authors propose a cognitive forcing strategy to avoid the pitfall of making judgments about the clinical superiority of an intervention on the basis of statistical significance alone.
British Journal of Anaesthesia
Transcarotid TAVR May Often Avoid General Anesthesia
Source: theheart.org | Medscape Cardiology Headlines [2016.10.18]
Using local anesthesia with conscious sedation might have cut the risk of periprocedural strokes a small transcarotid-TAVR series; the patients had severe peripheral vascular disease.
Heartwire from Medscape
Transcarotid TAVR Safer Under Local Anesthesia
Source: MedPage Today Nephrology [2016.10.17]
(MedPage Today) -- Early events only seen in general anesthesia cases in French series
Postoperative Delirium, Cognitive Changes Theme of ASA 2016
Source: Medscape Anesthesiology Headlines [2016.10.21]
New data from major clinical trials, the effect of anesthesia on the brain, and chronic opioid use will be addressed at Anesthesiology 2016.
Medscape Medical News
Published Studies Related to Marcaine (Bupivacaine)
Pre-emptive peritonsillar dexamethasone vs. levobupivacaine infiltration for
relief of post-adenotonsillectomy pain in children: a controlled clinical study. 
pediatric adenotonsillectomy patients... CONCLUSION: Peritonsillar dexamethasone infiltration was more effective than both
Intra-articular bupivacaine reduces postoperative pain and meperidine use after
total hip arthroplasty: a randomized, double-blind study. 
One hundred patients receiving unilateral total hip arthroplasty (THA) were
randomized to receive an intra-articular injection of 300mg bupivacaine or normal
saline after completion of surgery. Pain scores of the bupivacaine group were
significantly lower than those of the control group the first 12hours
postoperatively (all, P<0.001).
Efficiency of bupivacaine versus lidocaine and methylprednisolone versus placebo
to reduce postoperative pain and swelling after surgical removal of mandibular
third molars: a randomized, double-blinded, crossover clinical trial. 
swelling after surgical removal of mandibular third molars... CONCLUSIONS: Bupivacaine combined with methylprednisolone reduced the
A comparison of two different doses of bupivacaine in caudal anesthesia for
neonatal circumcision. A randomized clinical trial. 
anesthesia... CONCLUSIONS: Low volume high concentration caudal bupivacaine provided a similar
Spinal anaesthesia for pelvic surgery: low concentrations of lignocaine and
bupivacaine are effective with less adverse events. 
subarachnoid block for pelvic surgeries... CONCLUSION: [corrected] For subarachnoid block for pelvic surgeries longer than
Clinical Trials Related to Marcaine (Bupivacaine)
Marcaine Use in Laparoscopic Gynecological Surgery [Terminated]
Comparison of Standard and Minidose Spinal Anesthesia for Cesarean Section Operation Using Marcaine Spinal 0.5% Heavy [Not yet recruiting]
The objectives of this study is to test a combination of low dose local anesthetic
Bupivacaine diluted in patient's CSF with lipophilic opiate Fentanyl for optimal spinal
anesthesia during Cesarean Section. The dilution of Bupivacaine with CSF in our study would
result in effective spinal anesthesia with relatively limited motor block, quick recovery of
motor function and relatively long lasting analgesia. We expect lower incidence of side
effects with this combination than with convenient dose of Bupivacaine.
2% Lidocaine Plus 0.5% Bupivacaine Versus 0.5% Bupivacaine in Brachial Block for Creation of Arteriovenous (AV) Fistula [Recruiting]
ED50 and ED95 of Intrathecal Bupivacaine With or Without Epinephrine for Total Knee Replacement Arthroplasty [Completed]
This prospective randomized double-blind dose-response study is aimed to investigate the
ED50 and ED95 of intrathecal bupivacaine with or without epinephrine 100 mcg for total knee
Determination of the Effective Volume of 0.125% Bupivacaine-fentanyl 5mcg/mL in Labour Epidurals [Completed]
Different medications can be used as analgesics in labor epidurals. Bupivacaine is one of
the most commonly used drugs for that purpose. The efficacy of a certain medication injected
epidurally depends on the dose that is given. A certain dose can be administered in
different concentrations, which will consequently mean different volumes. Studies have been
done to determine volumes for different concentrations of bupivacaine. However, those
studies fall short in the sense that this information cannot be readily applicable in
clinical practice, as we don't use bupivacaine plain. The combination of bupivacaine and
fentanyl or sufentanil is common practice, as it is well established that the opioids will
reduce the concentration of local anesthetic required to produce optimal effect with the
least side effects.
This study is being planned to determine and compare the EV90 of the bupivacaine
0. 125%-fentanyl mixture for initiation of labor epidural analgesia, following the
administration of the 2 different test doses (3cc of lidocaine 2% or 3cc of the bupivacaine
0. 125%-fentanyl mixture) used in our Department.
Reports of Suspected Marcaine (Bupivacaine) Side Effects
Cardiac Arrest (8),
Anaesthetic Complication (6),
Respiratory Distress (5),
Brain Oedema (4),
Hypoxic-Ischaemic Encephalopathy (4),
Drug Ineffective (3),
Anaphylactic Reaction (3),
Anaphylactic Shock (3),
Oedema Peripheral (3), more >>