Marcaine with Epinephrine

Warning

Risk of cardiac arrest with use of Marcaine in obstetrical anesthesia

Contraindications

• Obstetrical paracervical block anesthesia
• Intravenous regional anesthesia (Bier Block)
• Known hypersensitivity to bupivacaine or to any local anesthetic agent of the amide-type or to other components of Marcaine / Marcaine with Epinephrine

Adverse Reactions

• Cardiac arrest
• Dose-related toxicity
• Methemoglobinemia
• Chondrolysis with intra-articular infusion
• Severe, persistent hypertension, cerebrovascular accidents, and bradycardia due to drug interactions

General Guidance

Dose adjustments should be made based on the patient's physical status, age, and other factors

Pregnancy

• Contraindicated in obstetrical paracervical block anesthesia
• Use with caution in pregnancy, as local anesthetics can cause maternal hypotension and fetal bradycardia

Nursing Mothers

• Use with caution, as it is not known whether bupivacaine is excreted in human milk

Pediatric Use

• Not recommended for use in pediatric patients younger than 12 years
• Continuous infusions of bupivacaine in pediatric patients have been reported to result in high systemic levels of bupivacaine and seizures

Geriatric Use

• Patients 65 years and over may be at increased risk for developing hypotension
• Dose adjustments should be made based on the patient's physical status and renal function