Bupivacaine; Lidocaine
• Duocaine
Indications/Dosage
• ophthalmic anesthesia
For local or regional anesthesia, specifically, ophthalmic anesthesia for ophthalmologic surgery (i.e., peribulbar, retrobulbar, or facial nerve block):
NOTE: Bupivacaine; lidocaine may be administered with or without epinephrine and/or hyaluronidase.
NOTE: In adults, the dosages for local anesthesia reported are general guidelines only. The actual dose depends on a variety of factors such as depth of anesthesia, extent of surgical procedure, degree of muscle relaxation required, duration of anesthesia and the patient's physical condition.
Retrobulbar dosage:
Adults: Inject 2—5 ml (20—50 mg lidocaine; 7—18 mg bupivacaine); a portion of the dose is injected retrobulbarly and the remainder may be used to block the facial nerve.
Elderly, debilitated or acutely ill Adults, Adolescents, and Children > = 12 years: Specific dosage guidelines not available. These populations should be given reduced doses commensurate with age and physical condition.
Children < 12 years: Safety and efficacy have not been established.
Peribulbar dosage:
Adults: Inject 6—12 ml (60—120 mg lidocaine; 22—45 mg bupivacaine), producing akinesia of the superior oblique muscle, the eyelids, and the orbicularis oculi muscle.
Elderly, debilitated or acutely ill Adults, Adolescents, and Children >= 12 years: Specific dosage guidelines not available. These populations should be given reduced doses commensurate with age and physical condition.
Children < 12 years: Safety and efficacy have not been established.
Maximum Dosage Limits:
NOTE: The dose of local anesthetics differs with the anesthetic procedure; the area to be anesthetized; the vascularity of the tissues; the number of neuronal segments to be blocked; the intensity of the block; the degree of muscle relaxation required; the duration of anesthesia desired; individual tolerance; and the physical condition of the patient.
•Adults
When given without epinephrine, do not exceed 0.18 ml/kg, and in general it is recommended not to exceed 12 ml (120 mg lidocaine; 45 mg bupivacaine). When used with epinephrine, do not exceed 0.28 ml/kg, and in general it is recommended not to exceed 20 ml (200 mg lidocaine; 75 mg bupivacaine).
•Elderly
Maximum dosage information not available.
•Adolescents
Maximum dosage information not available.
•Children
= 12 years: Maximum dosage information not available.
< 12 years: Safety and efficacy have not been established.
Patients with Hepatic Impairment Dosing
Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed. However, bupivacaine;lidocaine should be used with caution in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at greater risk of developing toxic plasma concentrations, particularly with repeated doses.
Patients with Renal Impairment Dosing
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
†non-FDA-approved indication
[Revised : 2010-09-07 10:39:00]
Drug Information Provided by Gold Standard Inc. © 2015
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Bupivacaine; Lidocaine• DuocaineIndications/Dosage• ophthalmic anesthesiaFor local or regional anesthesia, specifically, ophthalmic anesthesia for ophthalmologic surgery (i.e., peribulbar, retrobulbar, or facial nerve block):NOTE: Bupivacaine; lidocaine may be administered with or without epinephrine and/or hyaluronidase.NOTE: In adults, the dosages for local anesthesia reported are general guidelines only. The actual dose depends on a variety of factors such as depth of anesthesia, extent of surgical procedure, degree of muscle relaxation required, duration of anesthesia and the patient's physical condition.Retrobulbar dosage:Adults: Inject 2—5 ml (20—50 mg lidocaine; 7—18 mg bupivacaine); a portion of the dose is injected retrobulbarly and the remainder may be used to block the facial nerve.Elderly, debilitated or acutely ill Adults, Adolescents, and Children > = 12 years: Specific dosage guidelines not available. These populations should be given reduced doses commensurate with age and physical condition.Children < 12 years: Safety and efficacy have not been established.Peribulbar dosage:Adults: Inject 6—12 ml (60—120 mg lidocaine; 22—45 mg bupivacaine), producing akinesia of the superior oblique muscle, the eyelids, and the orbicularis oculi muscle.Elderly, debilitated or acutely ill Adults, Adolescents, and Children >= 12 years: Specific dosage guidelines not available. These populations should be given reduced doses commensurate with age and physical condition.Children < 12 years: Safety and efficacy have not been established.Maximum Dosage Limits:NOTE: The dose of local anesthetics differs with the anesthetic procedure; the area to be anesthetized; the vascularity of the tissues; the number of neuronal segments to be blocked; the intensity of the block; the degree of muscle relaxation required; the duration of anesthesia desired; individual tolerance; and the physical condition of the patient.•AdultsWhen given without epinephrine, do not exceed 0.18 ml/kg, and in general it is recommended not to exceed 12 ml (120 mg lidocaine; 45 mg bupivacaine). When used with epinephrine, do not exceed 0.28 ml/kg, and in general it is recommended not to exceed 20 ml (200 mg lidocaine; 75 mg bupivacaine).•ElderlyMaximum dosage information not available.•AdolescentsMaximum dosage information not available.•Children= 12 years: Maximum dosage information not available.< 12 years: Safety and efficacy have not been established.Patients with Hepatic Impairment DosingSpecific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed. However, bupivacaine;lidocaine should be used with caution in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at greater risk of developing toxic plasma concentrations, particularly with repeated doses.Patients with Renal Impairment DosingSpecific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.†non-FDA-approved indication[Revised : 2010-09-07 10:39:00]Drug Information Provided by Gold Standard Inc. © 2015• About Mosby's Nursing Consult• Contact Us• Terms and Conditions• Privacy Policy• Registered User Agreement
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