布比卡因
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.
各物種劑量
- Regional, epidural, perineural, or intrapleural analgesia · Up to 2 mg/kg · Perineural/Epidural/Intrapleural · q8h · As needed · Unlikely to be associated with systemic side effects at this dose. Onset is 20-30 minutes for epidural; duration is 6-8 hours.
- Regional, epidural, perineural, or intrapleural analgesia · Up to 2 mg/kg · Perineural/Epidural/Intrapleural · q8h · As needed · Unlikely to be associated with systemic side effects at this dose. Cats may be more sensitive to local anaesthetic toxicity; use conservative dosing.
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。
給藥途徑
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)
藥物相互作用
- Other local anaesthetics (e.g., lidocaine, mepivacaine) · Additive systemic toxicity; doses must be reduced when used concurrently. · major
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
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.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。