A review of significant current literature concerning bupivacaine hydrochloride (Marcaine) is presented with particular emphasis on clinical use in oral surgery. The major advantages compared with other presently used local anaesthetics are an increased duration of action and a favourable potency-to-toxicity ratio. Bupivacaine HCL (1-butyl-2', 6' pipecoloxylidide hydrochloride)* is a long-acting amide local anaesthetic (Fig. 1). First synthesised in 1957 by Ekernstam at A. B. Bafors Laboratories in Molndel, Sweden, this drug has undergone trials and received varying degrees of acceptance. Bupivacaine is a potent local anaesthetic with unique characteristics in the amide group of local anaesthetics. Local anaesthetics are used in regional anaesthesia, epidural anaesthesia, spinal anaesthesia, and local infiltration. Local anaesthetics generally block the generation of the action potential in nerve cells by increasing the threshold for electrical excitation. This activity reviews the mechanism of action, adverse event profile, toxicity, dosing, pharmacodynamics, and monitoring of bupivacaine.
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2022: 6.012
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