Marcain (bupivacaine)

Marcain (bupivacaine) - Marcain has a slow onset of action (about 30 minutes for the full effect) but the duration of block can be 8 hours or more. It is the principal drug for spinal anaesthesia in the UK. We do not use it for routine outpatient injections because the delayed onset of action precludes the immediate diagnostic effect available with lidocaine, and if there is an adverse effect it will take a long time to dissipate. There is no evidence of any long-term benefit from using bupivacaine instead of lidocaine9 4 . Compared to placebo, the effect of intraarticular bupivacaine wears off in less than 24 hours2 2 8 .