If you are going to have surgery soon, one of your biggest fears is the pain that will come after it. "Oh, doctor, will it hurt a lot afterwards?" We all ask, right? That fear is justified. But, fortunately, today, thanks to the advancement of medical science, there are many good ways to control the pain that occurs after surgery. So today we are going to talk about a special medicine that doctors use to control this pain. It is called Bupivacaine.
What is this Bupivacaine?
Simply put, Bupivacaine is a numbing medication that is given to numb the area around a surgical wound during or after surgery. It's like the numbing medication you give your gums before a tooth extraction, but it's a special, stronger type used for surgical wounds.
This is injected directly into the area where the surgery was performed, that is, into the tissues surrounding the wound. This temporarily numbs the nerves in that area and stops the pain signals from going to the brain. This means that you will feel much less pain for a few hours after the surgery. This means that you will be more relaxed during your recovery.
Things you need to tell your doctor before giving this medicine
Before giving you this medicine, your doctor will need to know your complete medical history. This is because some medical conditions require special care when using this medicine. Therefore, if you have any of the conditions listed below, be sure to tell your doctor about it. Don't ignore it, because your safety is the most important thing.
| Illness or condition | Why should you inform? |
|---|---|
| Allergy to Bupivacaine or other numbing medicine (e.g. Lidocaine) | To avoid causing a serious allergic reaction. |
| Heart disease | People with heart disease need special attention because the effects of this medication may be different. |
| Liver or Kidney disease | Because it can affect the process of removing drugs from the body. |
| Low blood pressure | Because this medicine can lower blood pressure even further. |
| Lung diseases (e.g. asthma, COPD) | To be aware of the risk of respiratory problems. |
| G6PD deficiency | This is a rare blood-related condition that requires special care. |
| Being pregnant, trying to get pregnant, or breastfeeding | To consider the possible effects on the child and make the best decision. |
How do you use this medicine?
The important thing is, this is not a medicine you can take home. Bupivacaine injections are only given in a hospital or clinic by a trained doctor or nursing staff.
It is usually injected into the tissue around the surgical wound during or after surgery, so you don't have to worry about missing a dose.
If there is a sudden problem of overdose of this medicine, it will happen in a hospital and the medical staff will take immediate action. In such a case, they can also call the National Poisons Information Centre at the Colombo National Hospital and get the necessary advice. Also, the patient will be immediately admitted to the Emergency Treatment Unit (ETU) and the necessary treatment will be provided.
Other drugs that may interact with Bupivacaine
If you are taking any other medications, it is important to tell your doctor about them as well. Some medications can interact with Bupivacaine and cause unwanted effects. Tell your doctor about all the medications you are taking, not just those prescribed by your doctor, but also painkillers, vitamins, and herbal remedies you buy from a pharmacy.
What are the possible side effects?
Like any medicine, Bupivacaine can cause side effects in some people. However, not everyone gets them. Some are serious and need to be reported immediately. Others are normal and go away after a while. Let's see what they are.
| Side effect | Description |
|---|---|
| Side effects that you should report to your doctor or nurse immediately: | |
| Serious allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat, difficulty breathing. |
| Changes in heart rate | Feeling like your heart is beating fast or irregularly, dizziness, chest pain. |
| Central nervous system depression (CNS depression) | Slow or shallow breathing, excessive sleepiness, and confusion. |
| Seizures | Body shaking, twitching. |
| Methemoglobinemia | Difficulty breathing, blue/gray discoloration of the mouth, fingernails, or skin, extreme tiredness, headache. (This is a rare but serious condition). |
| Things that are usually not serious, but should be reported to the doctor if they persist | |
| Dizziness, headache | It's probably temporary, but let me know if it persists. |
| Vomiting, nausea | This can also commonly occur after surgery. |
| Change in taste in the mouth | Feeling a metallic taste in the mouth. |
| Ringing in the ears | Hearing a ringing sound in the ears. |
Take care of the numb area!
This is very important. Since the area where your surgery was performed is numbed by the Bupivacaine injection, you will not feel any pain in that area. Therefore, there is a high chance of injury or accident in that area. For example, you may not feel any pain if you get hit, cut, or burned anywhere in that area. Therefore, you should be very careful with that area until the numbness is completely gone. Be careful about that.
Take-Home Message
- Bupivacaine is a numbing injection that is only given in a hospital to reduce pain after surgery.
- Be sure to tell your doctor about all of your medical conditions (especially heart, liver, and kidney disease) and all medications you are taking.
- Protect the area that is numb from the effects of the medication from harm. Be extra careful as you won't feel any pain.
- Notify medical staff immediately if you notice any serious side effects such as difficulty breathing, chest pain, or facial swelling.
- If you have any questions or concerns about this medication or your condition, don't be afraid to talk to your doctor or nurse.
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