Chirocaine

Chirocaine is a brand name for bupivacaine hydrochloride, a long-acting amide local anesthetic used to provide regional anesthesia and analgesia during surgical procedures. It is supplied as sterile solutions intended for infiltration, peripheral nerve blocks, and regional techniques such as epidural or intrathecal administration, depending on the preparation and local regulations.

Medical uses include local infiltration during minor surgery, nerve blocks for regional anesthesia, and epidural or intrathecal anesthesia for major surgery or labor analgesia. It may be used for postoperative pain relief through wound infiltration or continuous epidural infusion. Formulations may include or exclude vasoconstrictors such as epinephrine to prolong effect and reduce systemic absorption; the choice depends on the procedure and patient factors.

Mechanism of action: bupivacaine blocks voltage-gated sodium channels in nerve membranes, preventing nerve impulse initiation and propagation. Its onset is relatively slower than shorter-acting agents, and the duration of sensory blockade typically lasts several hours, depending on dose, location, and whether a vasoconstrictor is used. The duration is longer in epidural or intrathecal administration compared with surface or infiltration techniques.

Safety and precautions: As a potent local anesthetic, inadvertent intravascular injection or high plasma concentrations can cause serious central nervous system or cardiovascular toxicity. Possible adverse effects include numbness, dizziness, tinnitus, seizures, hypotension, bradycardia, and arrhythmias. Cautions include hepatic impairment, pregnancy, significant cardiac disease, and adult age considerations. When epinephrine is included, there is an increased risk of adverse cardiovascular effects in susceptible individuals. Administration should be performed by trained professionals with appropriate monitoring and resuscitation equipment available.

Regulatory status: Chirocaine is used in many countries under various approvals, with indications and available concentrations dependent on local regulatory guidelines.