Posology : מינונים

4.2      Posology and method of administration
Marcaine Spinal 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. The dose must be adjusted for the individual patient.
The dose must be reduced in the elderly patients and patients in the late stages of pregnancy.

Indication           Dose ml           Dose mg       Time to               Duration of onset of              effect in effect in             hours minutes               (approx.)
(approx.)
Surgery on           2-4 ml            10-20 mg      5-8 min               1.5-4 hours lower limbs,
including hip surgery

The recommended injection site is the L3-L4 intervertebral space.
There is currently no clinical experience of doses higher than 20 mg. Intravenous access must be established prior to administration of Marcaine Spinal.

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