L-Ascain

Singapore • Dexa Medica

Indication

Adults
Levobupivacaine is indicated in adults for:

Surgical anesthesia

  • Major: epidural (including Caesarean section), intrathecal, peripheral nerve block.
  • Minor: local infiltration, peribulbar block in ophthalmic surgery.
  • For cesarean section, the 7.5 mg/ml concentration is not recommended (see Contraindications, Warning and Precautions).

Pain management

  • Continuous epidural infusion, single or multiple bolus administration for postoperative, labor, or chronic pain.
  • For continuous epidural analgesia, levobupivacaine may be administered in combination with epidural fentanyl, morphine, or clonidine.
  • For labor analgesia, the 7.5 mg/ml concentration is not recommended (see Contraindications, Warning and Precautions, Use during Pregnancy and Lactation-Labor and Delivery).

Children
Levobupivacaine is indicated in children for infiltration analgesia (iliolinguinal/iliohypogastric blocks) (see Recommended Dosage).

Composition

Levobupivacaine 5 mg/ml in 10 ml ampoule

Package

5 ampoules of 10 ml

Dosage Forms

Injection

ATC Classification

N01B

Warning

Alcohol
Not Recommended
This item should not be used with alcohol.
Machinery
Not Recommended
This item should not be used while operating heavy machinery.
Pregnancy
Consult Your Doctor
Safety of this item for use during pregnancy has not been established. Please consult your doctor.
Lactation
Consult Your Doctor
Safety of this item for use during lactation has not been established. Please consult your doctor.

Dosage

0 to 12 Years Old

Surgical anesthesia:
Local infiltration (0.25%) 0.50 ml/kg/side or (0.5%) 0.25 ml/kg/side. The maximum recommended dose for infiltration analgesia (ilioinguinal-iliohypogastric block) is 1.25 mg/kg/side.

12 Years Old and Above

Surgical anesthesia:

  • Epidural for surgery (0.5-0.75%) 10-20 ml [50-150 mg]
  • Epidural for Caesarean section (0.5%) 15-30 ml [75-150 mg]
  • Peripheral nerve (0.25-0.5%) 1-40 ml [maximum 150 mg]
  • Intrathecal (0.5%) 3 ml [15 mg]
  • Ophtalmic (0.75%) 5-15 ml [37.5-112.5 mg]
  • Local infiltration (0.25%) 1-60 ml [maximum 150 mg]

Pain management:

  • Labor analgesia (epidural bolus with 0.25%) 10-20 ml [25-50 mg]
  • Labor analgesia (epidural infusion with 0.125%) 4-10 ml/hour [5-12.5 mg/hour]
  • Postoperative pain (epidural infusion with 0.125%) 10-15 ml/hour or (0.25%) 5-7.5 ml/hour [12.5- 18.75 mg/hour]

Epidural doses up to 375 mg have been administered incrementally to patients during a surgical procedure.

The maximum dose in 24 hours for intraoperative block and postoperative pain management was 695 mg.

The maximum dose administered as a postoperative epidural infusion over 24 hours was 570 mg.

The maximum dose administered to patients as a single fractionated injection was 300 mg for brachial plexus block.

For Caesarean section, the maximum recommended dose is 150 mg.

Route of Administration:
Epidural, intrathecal injection.

Administration
The rapid injection of a large volume of local anesthetic solution should be avoided and fractional (incremental) doses should always be used. The smallest dose and concentration required to produce the desired result should be administered. The use of levobupivacaine hydrochloride monohydrate is not recommended for more than 24 hours.

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