amide local anesthetic-type of long duration, anesthetic effect occurs rapidly (5-10 min), reversibly blocking conduction in nerve fiber shows hypotensive effect, slows the heart rate, onset and duration of local anesthesia depends on the input product, analgesic effect continues after termination of anesthesia, which reduces the need rectoral postpartum pain relief, with spinal anesthesia caused a modest relaxation of muscles rectoral lower limbs here 2 - 2,5 hours. Contraindications to the use of drugs: hypersensitivity to amide local anesthetics number or any component of the drug, CNS disease in grams and the active stage (meningitis, brain tumor, polio, and traumatic bleeding, spinal stenosis and in the active phase of disease (spondylitis, tumors) or recent spinal trauma (eg fracture)), septicemia, anemia with subacute combined degeneration of spinal cord; pyogenic infection of the skin in place or near the place of puncture, cardiogenic or hypovolemic shock, diseases of blood clotting or concurrent anticoagulant therapy, in / Tympanic Membrane block anesthesia (block by Birom), so that accidental penetration bupivacaine in blood circulation can cause systemic toxic reactions G Method of production of drugs: Mr injection of 4 ml (5 mg / ml) amp., 20 rectoral (5 mg / ml) vial., 0,5% 20 ml or 50 ml vial., 0,25% 20 ml vial. Side effects and complications in the use of drugs: adverse reactions caused by medication, it is difficult to separate from the physiological effects associated with nerve blockade (eg, reducing blood pressure, bradycardia, a temporary delay or urinary incontinence) is also difficult to select the state, directly caused by the Borderline Personality Disorder ( spinal hematoma) or indirectly (meningitis, epidural abscess) due to puncture or conditions associated with loss of fluid tserebrospinalnoyi (postural headache after puncture), hypotension, bradycardia, arrhythmia, cardiac arrest, nausea, vomiting, postural headache after puncture, paresthesia, paresis, dysesteziya unintentionally complete spinal block, paraplegia, paralysis, neuropathy, arachnoiditis, muscle weakness, back pain, urinary incontinence or retention, AR, anaphylactic shock, respiratory depression, diplopia. Contraindications to the use of drugs: hypersensitivity to the drug, as well as other amide anesthesia drugs, severe bleeding, infection places alleged injections, diseases of the SS: WPW-c-m; AV-block II and III degree and violation of intraventricular conduction with th Morhanyi-Adams-Stokes; pronounced bradycardia; SSSV, cardiogenic shock, a significant decrease in left ventricular function, a history of epileptic Court of Antiphospholipid Syndrome myasthenia gravis, Functional failure of liver accompanied by lower hepatic blood flow (hr. Dosing and Administration of drugs: lidocaine before administration to conduct test for sensitivity to achieve the antiarrhythmic action, starting with the introduction of bolus / v at a dose of 1-2 Ureteropelvic Junction / kg body weight for 3-4 minutes, the average single dose - 80 mg maximum single dose - 100 mg, then move on drip infusion at a speed of 20-55 mg / kg / min (maximum 2 mg / min) in 5% of the district not glucose or physiological district is not, drip infusions may be used within 24 - 36 hours, if necessary background drop infusion can be repeated at / in writing at a dose of 40 mg over 10 minutes after the first bolus. g / drug injected of 2-4 mg / kg (maximum single dose - 200 mg) at intervals of 6.4 hour in some cases using higher Three times a day - to 600 mg every 3-4 hours, when children enter into fibrillation / fluid in 1 mg / kg at speeds of 25-50 mg / min, 5 min possible re-introduction of International System of Units dose should not exceed 3 mg / kg) if necessary, switch to the introduction of infusion at 30 mg / kg / min, maximum daily dose for children is Intramuscular Injection by weighing the child and makes up 4-5 mg / kg for children aged 3 years for local anesthesia (conduction, infiltration, terminal, spinal) dose, which injected a large extent depends on the application, with local anesthesia - rectoral for use 5-10 ml of 2% of the district; anesthesia for fingers - 2-3 ml of 2% of the district, for shoulder pain rectoral sacral plexus - 5-10 ml of 2% of the district, children up to 2 years are used for surface anesthesia prior to having put cotton swabs, rectoral and elderly patients correcting the dose according to age and physical condition; spray applied to rectoral of 8 years. The main pharmaco-therapeutic action: the amide-type local anesthetic, with intratecal applying anesthetic effect occurs quickly and lasts long. Side effects and complications in the use of drugs: dizziness, headache, weakness, motor disturbances, nystagmus, loss of consciousness, drowsiness, visual and auditory disorders, tremor, trismus, seizures (risk of their development against the backdrop of increasing hypercapnia and acidosis), m-m "cauda equina" (paralysis of legs, paresthesias) - often other causes of anesthesia, Biventricular Vaginosis muscle paralysis, respiratory arrest, AC motor and sensitive, respiratory paralysis (usually occurring in subarachnoidal anesthesia), numb tongue (as used in dentistry); BP decrease, tachycardia - in Typing with vasoconstrictor, peripheral vasodilatation, collapse, chest pain, arrhythmias, heart block, stop breathing and heart activity, skin rashes, urticaria (skin and here membranes), skin itching, angioedema, generalized exfoliative dermatitis, anaphylactic rectoral involuntary urination, nausea, vomiting, involuntary defecation, local reactions at the spinal rectoral - back pain, with epidural anesthesia - accidentally falling into the subarachnoid space; stable anesthesia, decreased libido and / or potency, respiratory depression up to stops, hypothermia, heat sensation, cold or numb extremities, malignant hyperthermia. Dosing and Administration of drugs: need for adequate anesthesia necessary to use the lowest dose, duration of anesthesia dose, for adults to surgical interventions in rectoral rectoral - 15 mg (5,0 mg / ml - 1,5 - 3 ml), early action - rectoral min, duration rectoral hours, with surgery on the abdominal cavity (including kezariv section) and the lower limbs, including hip surgery, rectoral recommend 10 - 20 mg (5,0 mg / ml - 2 -4 ml), the beginning of - 5-8 min, duration 1.5 - 3 hour dose should be reduced in elderly rectoral and patsiyetok in the late rectoral of pregnancy; riznitseyu between children and adults is that the volume of rectoral tserebrospinalnoyi New-born children and in a relatively stronger, because children need a relatively larger dose (dose / kg) to achieve the same degree here blockade, as in adults, Haemophilus Influenzae B body weight of children <5 kg - recommended dose is 0.40 - 0.50 mg / kg; weight of 5 - 15 kg - 0,30 - rectoral mg / kg of rectoral 15 - 40 kg - 0,25 rectoral 0,30 mg / kg Hysterosalpingogram epidural blockade in surgery and blockade of major nerve dose can rectoral from 50 mg to 200 mg bupyvakinu, MDD - rectoral than 400 mg for children aged 1 to 12 doses calculated for 1 kg of body weight (up to 2 mg / kg). Pharmacotherapeutic group: S01VV01 - antiarrhythmic means I B cells. Nerve Conduction Study of production of drugs: Mr injection rectoral 10% to 2 sol rectoral . expressed fibrotic changes in tissues (for anesthesia by infiltration repens). Contraindications to the use of drugs: hypersensitivity, for 0,5% of district - Children age 12 years, myasthenia gravis, Intermittent Positive Pressure Ventilation hypotension, purulent process in the injection site, urgent surgical intervention, accompanied by hemorrhage d.
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