Bupicasan Dosage/Direction for Use

Dosage recommendation: The dosage in the table are those thought to be necessary for the production of a successful block and should be regarded as guideline for use in the average adult. Regarding spread and duration times, there are wide individual variations and it is impossible to be precise. (See table.)


Click on icon to see table/diagram/image


Spinal injections should only be made after the subarachnoid space has been clearly identified by lumbar puncture. No drug should be injected until clear cerebrospinal fluid (CSF) is seen to escape from the spinal needle, or is detected by aspiration.
Failure of spinal anaesthesia has been reported in 1-5% of the patients. One reason for failure could be intrathecal maldistribution of the local anaesthetic e.g. entrapment in the caudal end of the dural sack or within a "pocket" with restricted communication to the major CSF space. In such cases a better spread, i.e. a sufficient block, may be achieved after temporary change(s) in the patient's position. If a supplementary block is necessary, it should be performed at a different level and with a reduced volume of the local anaesthetic. Only one extra attempt should be made.
The following dosage recommendations should be regarded as guide for use in the average adult. The effects of spinal administration of BUPICASAN SPINAL 0.5% HEAVY exceeding 20 mg have not been reported.
The use of spinal anaesthesia in children requires a through knowledge of differences between adults and children to enable the administration of adequate doses of the drug used. A relatively a high CSF volume is found in infants and neonates. They therefore require a relatively larger dose/Kg to produce the same level of block.
In small children the nerves are less myelinated, allowing easier diffusion and a more rapid onset of anaesthesia.
The hypotension usually seen after spinal blocks in adults is uncommon in children under the age of 8.
BUPICASAN SPINAL 0.5% HEAVY may be used in children. The following doses are recommended: 0.40-0.50 mg/kg for infants up to 5 kg.
0.30-0.40 mg/kg for children weighing between 5 and 15 kg.
0.25-0.30 mg/kg for children weighing more than 15 kg.
As the solutions are free from preservatives, they should be used immediately after opening of the container. Any remaining solution should be discarded.
Since BUPICASAN SPINAL 0.5% HEAVY contains dextrose/glucose, caramelization may occur during autoclaving. This preparation should therefore not be resterilized.