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).

Perioperative epidural steroids 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) ¹⁾. However, the combination of systemic steroids 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 muscles at incision and closure, may reduce hospital stay and post-op narcotic requirements ²⁾.