Adult Lower-limb urological & perineal surgery 1.5-3 mL (7.5-15 mg) on L3/4/5 site of inj, sitting position. Lower abdominal operations (including caesarean section) 3-4 mL (15-20 mg) on L2/3/4 site of inj, horizontal position. Childn >15 kg 0.25-0.30 mg/kg, 5-15 kg 0.30-0.40 mg/kg. Infant ≤5 kg 0.40-0.50 mg/kg.
Hypersensitivity to amide-type local anaesth. Acute active CNS diseases (eg, meningitis, poliomyelitis & cranial haemorrhage). Presence of active TB or metastatic lesions in vertebral column. Septicaemia. Pernicious anemia w/ subacute combined degeneration of spinal cord. Pyrogenic skin infection or adjacent to the puncture site. Cardiogenic or hypovolaemic shock. Coagulation disorders or ongoing anticoagulant treatment.
Not for IV inj. Place IV access or IV infusion before starting the spinal anaesth. May cause hypotension & bradycardia. Hypotension in patient w/ hypovolaemia due to haemorrhage or dehydration & in those w/ aortocaval occlusion due to abdominal tumors or the pregnant uterus in late pregnancy. Possible very high blockades w/ paralysis of intercostals muscles & even diaphragm, especially in pregnancy. Chronic neurological disorders (eg, multiple sclerosis, old hemiplegia due to stroke). May temporarily impair locomotion & alertness.
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