presents
Wheeless' Textbook of Orthopaedics

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

Bilateral Shoulder Chondrolysis Following Arthroscopy. A Report of Two Cases













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

Last updated by Clifford R. Wheeless, III, MD on Saturday, November 29, 2008 8:43 pm