Bupivacaine

Anaesthesia for Biliary and Pancreatic Surgery

“…The solution is made up by drawing up equal parts of lignocaine 1.5 % and bupivicaine 0.5 % with 1:200 000 adrenaline into the same syringe. Two 20-ml syringes are filled in this way: this mixture has the following advantages: (1) Lignocaine acts marginally more quickly than bupivicaine and in my experience allows an earlier start to the operation than if bupivicaine alone is used: it acts in 10-15 min as compared with 20-25 min (Steel 1968, Watt et al 1968, Galindo et al 1975, Lund et al 1975). (2) Bupivicaine 0.25 % seldom gives rise to much motor paralysis either during the operation or afterwards (Downing 1969): the sensory block combined with general anesthesia is sufficient to produce good muscle relaxation, but allows spontaneous respiration.…”