Marcaine Spinal Side Effects

Generic Name: bupivacaine,bupivacaine hydrochloride

Please note - some side effects for Marcaine Spinal may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects of Marcaine Spinal - for the Consumer

Marcaine Spinal Solution

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Marcaine Spinal Solution:

Mild dizziness or drowsiness; nausea; vomiting.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; changes in hearing; chest pain; excitement; headache; inability to control bowels and urine; irregular heartbeat; numbness that lasts for more than a few hours; paralysis; restlessness; ringing in the ears; seizures; severe dizziness or drowsiness; shivering; tremors; urinary retention.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

Side Effects by Body System - for Healthcare Professionals

General

In general, reactions to bupivacaine are typical of those associated with other amide-type local anesthetics. A major cause of adverse reactions to these drugs is high plasma levels, which may be due to overdosage, rapid absorption from injection site, diminished tolerance, accidental intravascular injection, or slow metabolic degradation.

The most common side effects that require immediate countermeasures are related to the central nervous system and the cardiovascular system. These reactions are generally dose related and due to excessive plasma levels. Accidental subarachnoid injection may result in underventilation or apnea. Hypotension caused by loss of sympathetic tone and respiratory paralysis or underventilation caused by cephalad extension of the motor level of anesthesia may occur and may lead to cardiac arrest if untreated. Elderly patients over 65 years of age, especially those with hypertension, may be at higher risk of hypotensive effects. Factors influencing plasma protein binding, such as acidosis, altered protein production due to systemic diseases, or competition with other drugs for protein binding sites, may decrease tolerance.

Nervous system

Nervous system side effects following epidural or caudal anesthesia have included spinal block (including high or total spinal block); hypotension secondary to spinal block; urinary retention; fecal and urinary incontinence; loss of perineal sensation and sexual function; persistent anesthesia, paresthesia, weakness, paralysis of the lower extremities and loss of sphincter control all of which may have slow, incomplete, or no recovery; headache; backache; septic meningitis; meningismus; arachnoiditis; slowing of labor; increased incidence of forceps delivery; shivering; and cranial nerve palsies due to traction on nerves from loss of cerebrospinal fluid. Neurologic effects following other procedures or routes of administration may include persistent anesthesia, paresthesia, weakness, paralysis, all of which may have slow, incomplete, or no recovery. Central nervous system side effects have included excitation and/or depression, restlessness, anxiety, dizziness, tinnitus, blurred vision, tremors, convulsions, drowsiness, unconsciousness, respiratory arrest, nausea, vomiting, chills, and pupil constriction.

Cardiovascular

Cardiovascular side effects have included myocardial depression, decreased cardiac output, heart block, hypotension, bradycardia, ventricular arrhythmias (including ventricular tachycardia and ventricular fibrillation), and cardiac arrest.

Respiratory

Respiratory side effects have included respiratory paralysis or underventilation (due to upward extension of the level of spinal anesthesia) and may lead to secondary hypoxic cardiac arrest if not treated.

Other

Other side effects have included a high spinal (characterized by paralysis of the legs, loss of consciousness, respiratory paralysis, and bradycardia) following accidental subarachnoid injection.

Hypersensitivity

Hypersensitivity side effects have included allergic-type reactions including signs such as urticaria, pruritus, erythema, angioneurotic edema (including laryngeal edema), tachycardia, sneezing, nausea, vomiting, dizziness, syncope, excessive sweating, elevated temperature, and possibly, anaphylactoid-like symptomatology (including severe hypotension).

Gastrointestinal

Gastrointestinal side effects have included nausea and vomiting during spinal anesthesia.

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