Marcain 0.5% Spinal Heavy Dosage/Direction for Use

Marcain Spinal Heavy should only be used by clinicians with experience of regional anaesthesia or under their supervision. The lowest possible dose for adequate anaesthesia should be used.
The doses given as follows are guides for adults and the dosage should be adjusted to the individual patient.
The dose should be reduced in the elderly and in patients in the late stages of pregnancy. (See Table 1).

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The recommended site of injection is below L3-L4 intervertebral space. There is currently no experience of doses higher than 20 mg.
A spinal injection is given only after the subarachnoid space has been clearly identified by means of lumbar puncture (clear cerebrospinal fluid runs out via the spinal needle or is seen on aspiration). In the event of unsuccessful anaesthesia, a new attempt to administer the drug should only be made by injecting at a different level and with a smaller volume. One cause of lack of effect may be poor intrathecal distribution of the drug, and this can be helped by altering the patient's position.