Bupicasan Adverse Reactions

In general, almost all the side effects seen with spinal anaesthesia are due to the nerve blockade itself and not to the drug used. These effects include hypotension, bradycardia and post-spinal headache. Other undesirable effects in connection with spinal anaesthesia are: High or total spinal blockade: A rare, though severe, adverse reaction following spinal anaesthesia is high or total spinal blockade resulting in cardiovascular and respiratory depression. The cardiovascular depression is caused by extensive sympathetic blockade which may result in profound hypotension and bradycardia, or even cardiac arrest. Respiratory depression is caused by blockade of the innervation of the respiratory muscles, including diaphragm.
Neurological complication: Neurological damage is a rare, though recognized, consequence of spinal anaesthesia. It may have one of several causes such as direct injury to the spinal cord or spinal nerves, anterior spinal artery syndrome, injection of an irritant substance, injection of a non-sterile solution or the development of a space occupying lesion (haematoma or abscess) within the spinal canal. These may result in localized areas paraesthesia or anaesthesia, motor weakness, loss of sphincter control and paraplegia. Occasionally these are permanent. Neurological complications of this type have been reported with all local anaesthetics used for spinal anaesthesia.
Allergic reactions: Allergic reactions (in the most severe instances anaphylactic shock) to local anaesthetics of the amide type are rare.
Acute systemic toxicity: Like all local anaesthetic drugs, Bupivacaine Hydrochloride may have acute toxic effects on the central nervous and cardiovascular system, if given in high doses. This is especially the case if the injection is made intravascularly. However, the dose required for spinal anaesthesia is so small (20% or less than that required for epidural anaesthesia) that acute systemic toxicity is extremely unlikely and has not been reported.