Posology : מינונים

4.2.     Posology and method of administration
Marcaine Spinal Heavy should only be used by physicians with experience of regional anaesthesia or under the supervision of such a physician. The lowest possible dose for adequate anaesthesia should be sought.

The doses given below are guidelines for adults and the dose must be adjusted for the individual patient.
The dose must be reduced in the elderly and patients in the late stages of pregnancy.


Onset time       Duration
Indication               Dose               Dose minutes           hours ml                mg
(approx.)        (approx.)
Urological
1.5-3 ml        7.5-15 mg      5-8 min        2-3 hours surgery
Surgery in the lower extremities, including          2-4 ml         10-20 mg       5-8 min        2-3 hours hip surgery
Abdominal surgery
(including caesarean            2-4 ml         10-20 mg       5-8 min        45-60 min section)

The recommended injection is in the L3-L4 intervertebral space.
There is currently no clinical experience of doses higher than 20 mg.

A spinal injection must not be given until the subarachnoid space has been clearly identified via lumbar puncture (clear cerebrospinal fluid exits via the spinal needle or is seen on aspiration). In the case of failed anaesthesia, only one new attempt should be made to administer the medicinal product, which should be given at a different level and with a smaller volume. One reason for lack of effect may be poor intrathecal distribution of the medicinal product, which may be rectified by adjusting the position of the patient.