Bupivacaine / Marcaine


- Dose:
    - maximum single doses should not > 150-175 mg w/o Epi;

- Local Anesthesia:
    - 5 ml to the maximal recommended dose (25 milligrams to maximal dosage) w/ 0.5% solution, which produces moderate to complete motor blockade;

- Arthroscopic surgery:
    - 30 mL of 0.75% bupivacaine was injected into knee joint is max dose;

- Post Op Anesthesia:
    - intra-articular injection of 30 cc of 0.5 % bupivacaine w/ 1:200,000 epinephrine;
          - peach serum levels are reached 30 min after injection;
          - in TKR may decrease need for narcotics by 25%;

- Toxic Levels:
    - 2,000 nonograms per ml (2 micrograms per ml) 



Anesthetic properties and toxicity of bupivacaine and lidocaine for infiltration anesthesia.

Bupivacaine infusion for iliac crest donor sites.

In vitro exposure to 0.5% bupivacaine is cytotoxic to bovine articular chondrocytes.

Chondrolysis after continuous intra-articular bupivacaine infusion: an experimental model investigating chondrotoxicity in the rabbit shoulder.

Postarthroscopic Glenohumeral Chondrolysis

Comparison of Ropivacaine and Bupivacaine Toxicity in Human Articular Chondrocytes

Bilateral Shoulder Chondrolysis Following Arthroscopy. A Report of Two Cases.

Chondrotoxicity of Low pH, Epinephrine, and Preservatives Found in Local Anesthetics Containing Epinephrine

Cytotoxic Effects of Ropivacaine, Bupivacaine, and Lidocaine on Rotator Cuff Tenofibroblasts



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Saturday, January 3, 2015 3:40 pm