ABBOCAINE SPINAL

Indications & Dose:

Onset of action: Within one minute, maxi-mum motor blockade and maximum dermatome level are achieved within 15 minutes inmost cases. Duration of sensory blockage (time to return of complete sensa-tion in the operative site or regression of two dermatomes) following a 12mg dose averages 2 hour with or without 0.2mg epinephrine.

DOSE

Adult 7.5 mg or 1.0 ml for lower extremity and perineal procedures including TURP and vaginal hysterectomy. 12mg or 1.6 ml for lower abdominal procedures such as abdominal hysterectomy, tubal ligation, and appendecectomy 6mg for vaginal delivery under spinal anaesthesia. The dose range of 7.5 mg to 10.5 mg 1 ml to 1.4 ml for caesarean section under spinal anaesthesia.

Below 18 years, cannot recommended

Contraindications:

Side Effects:

Hypotension. Nausea and vomiting are frequently associated with hypotensive episodes.  High doses, may lead to high plasma levels and related depression of the myocardium, decreased cardiac output, bradycardia, heart block, ventricular arrhythmias, and possibly,cardiac arrest. Excitement and/or depression. Restlessness, anxiety, dizziness, tinnitus, blurred vision or tremors may occur, possibly proceeding to convulsions.  Drowsiness marging into unconsciousness and respiratory arrest. Urticaria, pruritus, erythema,  angio-neurotic edema (including laryngeal edema) tachycardia, sneezing, nausea, vomiting, dizziness, syncope, sweating, elevated temperature and possibly, anaphlactoid like symptomatology (including severe-hypotension). Cross sensitivity 

Cautions:

Precautions:

Not injected during uterine contractions, should not be used concomitantly with ergot-type oxytocic drugs, because a severe persistent hypertension may occur.  In patients receiving monoamine oxidase inhibitors (MAOI) or antidepressant of the triptyline or pramine types, because severe prolonged hypertension may result. Severe distur- bances of cardiac rhythm, shock, or heart block. Patients with hepatic disease.

PREGNANCY : used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Maternal hypotension has resulted from regional anaesthesia.

Interaction:

Drug

Oxidase inhibitors or tricyclic antidepressants; may produce severe, prolonged hypertension.

Phenothiazines and butyrophenones;  may reduce or reverse the pressor effect of epinephrine. 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: