====== Bupivacaine ======

Bupivacaine is a local anaesthetic drug belonging to the amino amide group. It is commonly marketed under various trade names, including Marcain, [[Marcaine]] (Carestream Dental), Sensorcaine (Astra Zeneca) and Vivacaine (Septodont).
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Perioperative [[epidural steroid]]s after routine surgery for [[lumbar degenerative disease]] may result in a small reduction of post-op [[pain]], [[length of stay]], and the risk of not returning to work at 1 year, but most of the [[evidence]] originates from studies not using validated [[outcome]] assessment that favor positive results, and further study is recommended (various agents, dosages, co-administered drugs, and delivery methods were reported)
((Ranguis SC, Li D, Webster AC. Perioperative epi- dural steroids for lumbar spine surgery in degen- erative spinal disease. J Neurosurg Spine. 2010; 13:745–757)).
However, the combination of systemic [[steroid]]s at the start of the case (Depo-Medrol® 160 mg IM and [[methylprednisolone]] sodium succinate (Solu-Medrol®) 250 mg IV) combined with infiltration of 30 ml of 0.25% [[bupivacaine]] (Marcaine®) into the [[paraspinal muscle]]s at incision and closure, may reduce [[hospital stay]] and post-op narcotic requirements
((Glasser RS, Knego RS, Delashaw JB, et al. The Perioperative Use of Corticosteroids and Bipuvicaine in the Management of Lumbar Disc Disease. J Neurosurg. 1993; 78:383–387)).