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布比卡因

Bupivacaine

1-butyl-N-(2,6-dimethylphenyl)piperidine-2-carboxamide

局部麻醉劑PerineuralEpiduralIntrapleuralRegional狗貓

別名: Sensorcaine · Marcaine · Bupivacainum · Bupivacaine hydrochloride

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

Up to 2 mg/kgPerineural/Epidural/Intrapleural· q8h· As needed
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劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
Regional, epidural, perineural, or intrapleural analgesiaUp to 2 mg/kgPerineural/Epidural/Intrapleuralq8hAs needed🌍 EU
  • Regional, epidural, perineural, or intrapleural analgesia: Unlikely to be associated with systemic side effects at this dose. Onset is 20-30 minutes for epidural; duration is 6-8 hours.

貓

適應症劑量途徑頻次療程地區
Regional, epidural, perineural, or intrapleural analgesiaUp to 2 mg/kgPerineural/Epidural/Intrapleuralq8hAs needed🌍 EU
  • Regional, epidural, perineural, or intrapleural analgesia: Unlikely to be associated with systemic side effects at this dose. Cats may be more sensitive to local anaesthetic toxicity; use conservative dosing.

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概覽

布比卡因是一種強效、長效的醯胺類局部麻醉劑，廣泛應用於獸醫學中的區域麻醉、硬膜外麻醉及神經周圍鎮痛。與利多卡因相比，其起效較慢，但作用時間顯著延長（6-8小時）。

​警告：​ 若靜脈注射布比卡因具有高度心臟毒性。注射前必須回抽以確保針頭不在血管內。

作用機制

Bupivacaine produces reversible blockade of voltage-gated sodium channels in nerve fibres → prevents the influx of sodium required for depolarization → inhibits the propagation of action potentials → results in local anaesthesia and analgesia.

安全性與警告

禁忌症

  • Intravenous (IV) administration
  • Intravenous regional anaesthesia (Bier block)
  • Use of adrenaline-containing formulations at end-arterial sites (e.g., tail, digits, ears)
  • Use of adrenaline-containing formulations when significant systemic absorption is likely

不良反應

  • Severe cardiac arrhythmias (if injected intravascularly)
  • Motor blockade (paresis/paralysis of affected limbs)
  • CNS toxicity (seizures, tremors) at high systemic doses
  • Hypotension (especially with epidural use)

注意事項

​CRITICAL WARNING:​ Inadvertent intravascular injection may precipitate severe cardiac arrhythmias that are refractory to standard resuscitation treatments. Always aspirate prior to injection.

  • Lower doses should be used when systemic absorption is likely to be high (e.g., intrapleural analgesia).
  • Normal sterile precautions should be observed during administration.

藥物相互作用

Other local anaesthetics (e.g., lidocaine, mepivacaine)Major

Additive systemic toxicity; doses must be reduced when used concurrently.

監測

  • Aspiration for blood prior to injection (mandatory)
  • Electrocardiogram (ECG) during and after block placement
  • Blood pressure
  • Respiratory rate and effort (especially with epidural or intrapleural use)
  • Motor function recovery

藥物動力學

半衰期

狗Approximately 1.5 to 2 hours (systemic)貓Unknown, likely similar to or slightly longer than dogs

吸收

Systemic absorption depends on the site of injection, vascularity of the tissues, and presence of a vasoconstrictor (adrenaline). Intrapleural administration results in high systemic absorption.

分佈

Highly lipid soluble and highly protein bound. Distributes widely to all tissues.

代謝

Hepatic metabolism via cytochrome P450 enzymes.

排除

Excreted primarily in the urine as metabolites.

過量

Overdose or inadvertent IV injection leads to profound CNS toxicity (muscle twitching, seizures, coma) and cardiovascular toxicity (profound hypotension, bradycardia, ventricular arrhythmias, asystole).

​Clinical Pearl:​ Bupivacaine-induced cardiac arrest is notoriously resistant to standard CPR. Intravenous Lipid Emulsion (ILE) therapy (e.g., Intralipid 20%) is the specific antidote and should be administered immediately alongside standard resuscitation efforts.

可用產品

劑型

  • Injectable solution: 2.5 mg/ml (0.25%)
  • Injectable solution: 5.0 mg/ml (0.5%)
  • Injectable solution: 7.5 mg/ml (0.75%)
  • Injectable solution: 2.5 mg/ml with 1:200,000 adrenaline
  • Injectable solution: 5.0 mg/ml with 1:200,000 adrenaline

獸醫用

  • Marcain (POM)
  • Sensorcaine (POM)

人用標示

  • Marcain 0.25%, 0.5%, 0.75%
  • Marcain Heavy (with glucose for spinal anaesthesia)

各地核准狀態

United States✓ 已核准處方藥FDA/CVM
🐕 Dogs🐈 Cats

Nocita (bupivacaine liposome injectable suspension) is FDA approved for dogs and cats.

European Union✓ 已核准處方藥EMA
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

United Kingdom✓ 已核准處方藥VMD
🐕 Dogs🐈 Cats

POM-V

暫無法規資料: 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Store at room temperature (15-30°C). Do not freeze. Protect from light. Adrenaline-containing solutions are more sensitive to light and heat.

飼主須知

您的寵物接受了長效局部麻醉以控制疼痛。

  • 治療部位（如腿部）可能會在6至8小時內保持麻木和無力。
  • ​保護麻木部位：​ 確保您的寵物不會啃咬、抓撓或弄傷麻木的肢體，因為牠們在該區域感覺不到疼痛。
  • 限制寵物的活動，如果腿部無力，請協助牠們行走以防跌倒。
  • 如果您發現寵物出現嚴重嗜睡、肌肉顫抖或呼吸困難，請立即聯繫獸醫。

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