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Hyperbaric bupivacaine is a formulation of the local anesthetic bupivacaine that is made hyperbaric (denser than cerebrospinal fluid) by the addition of dextrose. It is an amide-type local anesthetic used primarily for spinal (subarachnoid) anesthesia. The addition of dextrose increases the solution's density, allowing it to spread predictably under gravity within the intrathecal space. Hyperbaric bupivacaine acts by blocking voltage-gated sodium channels on neuronal membranes, inhibiting nerve impulse generation and conduction and thus producing loss of sensation and motor function in targeted regions. It is commonly used for surgical anesthesia in procedures such as cesarean section, lower limb surgery, abdominal surgery, and urological procedures[4][5][7]. Its onset is rapid with a long duration of action.
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