|
| Interactions: | Hyaluronidase
Adverse Effect: an increased incidence of a systemic reaction to the anesthetic Clinical Management: Monitor patients for local anesthetic toxicity. Hyaluronidase effectively increases topical diffusion of local anesthetics. However, due to its propensity to increase the incidence of systemic reactions to local anesthetics and because there are newer anesthetic agents which penetrate very effectively, its use can no longer be justified.
Lignocaine
Adverse Effect: an increased risk of methemoglobinemia Clinical Management: Care should be employed when bupivacaine and lidocaine are used concurrently, especially in patients with other factors which may predispose them to methemoglobinemia.
Propofol
Adverse Effect: an increased hypnotic effect of propofol Clinical Management: In patients receiving bupivacaine in soft tissue before induction of anesthesia with propofol, downward dosage adjustments in propofol are necessary.
Verapamil
Adverse Effect: an increased risk of heart block Clinical Management: Clinicians should be aware of a potential interaction between verapamil and bupivacaine. If bupivacaine is to be given concurrently with verapamil, cardiac function should be closely monitored. |
|
|