Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
Free CME credits
Both our subscription plans include Free CME/CPD AMA PRA Category 1 credits.
Brand Name :
Chirocaine
(United States) [Available]Synonyms :
levobupivacaine
Class :
Local injectable anesthetics
Brand Name :
Chirocaine
(United States) [Available]Synonyms :
levobupivacaine
Class :
Local injectable anesthetics
Dosage forms and strengths Â
Infusion solution/injection-7.5 mg/mL, 5 mg/mL, 2.5 mg/mL (10 ml)Â Â
Premix solution for infusion- 1.25 mg/mL, 0.625 mg/mLÂ
(200 ml,100 ml)Â
Indicated for surgical anesthesia
Intrathecal- Administer 3 mL of solution containing 0.5% concentration
Epidural-Cesarean: Administer 0.5% solution within the range of 15-30 mL, with a maximum solitary dose of 150 mg
Surgery (not cesarean): Administer 10-20 mL of a solution containing 0.5%- 0.75% , with a maximum solitary dose of 150 mg
Extended surgical procedures could necessitate a maximum total dosage of 400 mg within a 24-hours
Dental- Administer 5 to 10 mL of a solution with a concentration between 0.5% -0.75%
Local infiltration-Administer 1-60 mL of a solution with 0.25 % concentration, with a maximum dosage not exceeding 150 mg (peribulbar block)
Ophthalmic- Administer 5-15 ml of a solution with 0.75 % concentration
Peripheral nerve-Administer 1-40 ml of a solution with 0.25% concentration or 1-30 ml of a solution with a 0.5% concentration with a maximum dosage not exceeding 150 mg
Indicated for pain management
Peri & postoperative pain (epidural infusion)- Administering a solution of 0.0625% at a rate of 10 -15 mL every hour, alternatively, infusing a 0.125% solution at the same rate of 10-15 mL every hour, or utilizing a 0.25% solution at 5-7.5 mL every hour
Administer at a maximum rate of 18.75 mg every hour
Maintain maximum cumulative dose at 400 mg each day Nevertheless, patients have shown good tolerance to postoperative dosages as high as 570 mg/24 hours (epidural bolus) in labor pain
: Administer 6-20 ml of solution with 0.25 % concentration
(epidural infusion) in Labor pain-Administer a solution containing 0.0625% concentration at a rate of 10-15 mL every hour
alternatively, administer a solution with 0.125% concentration at a rate of 4-10 mL every hour
Administer at a maximum rate of 12.5 mg every hour Maintain maximum cumulative dose at 400 mg each day
Dosage forms and strengthsÂ
Infusion solution/injection-7.5 mg/mL, 5 mg/mL, 2.5 mg/mL (10 ml)Â Â
Premix solution for infusion- 1.25 mg/mL, 0.625 mg/mLÂ
(200 ml,100 ml)Â
Indicated for surgical anesthesia
Local infiltration (iliohypogastric block/ Ilioinguinal) For children age greater than 6 months- less than 12 years
Administer 0.5 mL/kg/side solution with a concentration of 0.25%
The maximum dosage not to exceed 1.25 mg/kg/side
Administer 0.25 mL/kg/side solution with a concentration of 0.5%
The maximum dosage not to exceed 1.25 mg/kg/side
Refer adult dosingÂ
levobupivacaine: it may increase the risk of methemoglobinemia agents
levobupivacaine: it may increase the risk of methemoglobinemia agents
levobupivacaine: it may increase the risk of methemoglobinemia agents
levobupivacaine: it may increase the risk of methemoglobinemia agents
levobupivacaine: it may increase the risk of methemoglobinemia agents
may increase the risk or severity of methemoglobinemia when miltefosine is combined
may increase the QTc prolonging effect of QT-prolonging agents
may increase the toxic effect of Methemoglobinemia Associated Agents
may have an increasingly adverse effect when combined with bupivacaine
they increase the effect of neuromuscular blockage of neuromuscular-blocking agents
they increase the effect of neuromuscular blockage of neuromuscular-blocking agents
they increase the effect of neuromuscular blockage of neuromuscular-blocking agents
they increase the effect of neuromuscular blockage of neuromuscular-blocking agents
they increase the effect of neuromuscular blockage of neuromuscular-blocking agents
may have an increasingly adverse effect when combined with local anesthetics
may have an increasingly adverse effect when combined with local anesthetics
may have an increasingly adverse effect when combined with local anesthetics
may have an increasingly adverse effect when combined with local anesthetics
may have an increasingly adverse effect when combined with local anesthetics
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
levobupivacaine: they may enhance the serum concentration of CYP1A2 Inhibitors
levobupivacaine: they may enhance the serum concentration of CYP1A2 Inhibitors
levobupivacaine: they may enhance the serum concentration of CYP1A2 Inhibitors
levobupivacaine: they may enhance the serum concentration of CYP1A2 Inhibitors
levobupivacaine: they may enhance the serum concentration of CYP1A2 Inhibitors
The potential for increased CNS depression risk or seriousness occurs when levobupivacaine is used together with pinazepam
The potential for increased CNS depression risk or seriousness occurs when levobupivacaine is used together with pipecuronium
The potential for CNS depression may enhanced when levobupivacaine is used together with fencamfamin
When levobupivacaine is used together with niaprazine, the risk or seriousness of CNS depression is enhanced
When levobupivacaine is used together with levosulpiride, the risk or seriousness of CNS depression is enhanced
When levobupivacaine is used together with somatotropin, this leads to a rise in levobupivacaine metabolism
When cyclacillin is used together with levobupivacaine, this leads to increased risk or seriousness of methemoglobinemia
methemoglobinemia associated agents may enhance the adverse/toxic effect of local anesthetics
methemoglobinemia associated agents may enhance the adverse/toxic effect of local anesthetics
methemoglobinemia associated agents may enhance the adverse/toxic effect of local anesthetics
methemoglobinemia associated agents may enhance the adverse/toxic effect of local anesthetics
methemoglobinemia associated agents may enhance the adverse/toxic effect of local anesthetics
may increase the toxic effect
may increase the arrhythmogenic effect of inhalational anesthetics
may increase the toxic effect of methemoglobinemia associated agents
may have an increasingly adverse effect when combined with local anesthetics
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increased neuromuscular-blocking effect when combined with neuromuscular-blocking agents
may have an increasingly adverse effect when combined with local anesthetics
may have an increasingly adverse effect when combined with local anesthetics
may have an increasingly adverse effect when combined with local anesthetics
may have an increasingly adverse effect when combined with local anesthetics
may have an increasingly adverse effect when combined with local anesthetics
may increase the adverse effect of Methemoglobinemia Associated Agents
may increase the adverse effect of Methemoglobinemia Associated Agents
may increase the toxic effect of Methemoglobinemia Associated Agents
may increase the hypotensive effect of QT-Prolonging Inhalational Anesthetics
may increase the adverse effect of Methemoglobinemia Associated Agents
may increase the toxic effect of Methemoglobinemia Associated Agents
may increase the adverse effect of Methemoglobinemia Associated Agents
acetaminophen/doxylamine/dextromethorphanÂ
may enhance the toxic effect of Methemoglobinemia Associated Agents
may decrease the therapeutic effect of anesthetics
When levobupivacaine and abaloparatide are combined, the risk or seriousness of adverse events will rise
When levobupivacaine and acebutolol are combined, the risk or seriousness of adverse events will rise
When levobupivacaine and aliskiren are combined, the risk or seriousness of adverse events will rise
When levobupivacaine and amifostine are combined, the risk or seriousness of adverse events will rise
When levobupivacaine and amlodipine are combined, the risk or seriousness of adverse events will rise
levobupivacaine and acetophenazine together have the potential to increase risk or seriousness of CNS depression
levobupivacaine's rate of excretion may be reduced by acetylsalicylic acid, which might raise the serum level
levobupivacaine has the potential to lower the rate of excretion of aclidinium, leading to a possible elevation in serum levels
levobupivacaine has the potential to lower the rate of excretion of acrivastine, leading to a possible elevation in serum levels
When used with acyclovir, levobupivacaine's metabolism may be reduced
When adagrasib and levobupivacaine are combined, the risk or seriousness of methemoglobinemia could rise
When combined with adalimumab, levobupivacaine's metabolism can be enhanced
levobupivacaine's rate of excretion may be reduced by defovir dipivoxil, which might raise the serum level
Combining afatinib with levobupivacaine may enhance the risk or seriousness of methemoglobinemia
levobupivacaine has the potential to lower the rate of excretion of ancestim, potentially leading to elevated levels of serum
The combination of levobupivacaine can lead to a reduction in the metabolism of antipyrine
antrafenine has the potential to reduce the rate of excretion of levobupivacaine, potentially leading to elevated levels of serum
When apalutamide is combined with levobupivacaine, there is a potential for a reduction in the concentration serum of levobupivacaine
the risk of methemoglobinemia may be increased
the risk of methemoglobinemia can be increased
When levobupivacaine is aided by hesperetin, it reduces hesperetin’s metabolism
Actions and Spectrum:Â
Action:Â
like other local anesthetics, levobupivacaine works by blocking the generation and conduction of nerve impulses. It does this by inhibiting sodium ion influx through the voltage-gated sodium channels in nerve cell membranes. Sodium channels are crucial in transmitting nerve signals, including pain signals, to the brain. Through inhibiting these pathways, levobupivacaine hinders the conveyance of pain impulses from the nerves to the brain. This leads to a transient numbing effect and alleviation of pain in the specific region of its application.Â
Spectrum:Â
Local Anesthesia: levobupivacaine is primarily used as a local anesthetic. It hinders nerve signal transmission by preventing the entry of sodium ions through sodium channels present in the membranes of nerve cells. This prevents the generation and propagation of nerve impulses, leading to temporary loss of sensation in the targeted area.Â
Frequency not defined Â
Blurred visionÂ
ParaplegiaÂ
ParaesthesiaÂ
SyncopeÂ
SomnolenceÂ
UnconsciousnessÂ
ConvulsionsÂ
Hypersensitivity reactionsÂ
AnaphylaxisÂ
Allergic reactionÂ
Back painÂ
PyrexiaÂ
HeadacheÂ
DizzinessÂ
VomitingÂ
AnaemiaÂ
Nausea
HypotensionÂ
Black Box Warning:Â Â
None
Contraindication/Caution:Â Â
Known Allergy or Hypersensitivity: levobupivacaine, like any other medication, can cause allergic reactions in some individuals. If a patient has a known allergy or hypersensitivity to levobupivacaine or any related local anesthetics, its use should be avoided.Â
Severe Bradycardia or Heart Block: levobupivacaine has the potential to cause dose-dependent cardiotoxic effects, including heart rhythm disturbances such as bradycardia and heart block. It’s contraindicated in patients with severe heart rhythm abnormalities.Â
Hypovolemia: levobupivacaine can cause hypotension (low blood pressure) upon administration. It should be used with caution in patients who are hypovolemic or have inadequate circulating blood volume, as it may exacerbate hypotension.Â
Known Sensitivity to Local Anesthetics: Individuals who have shown excessive sensitivity or adverse reactions to other local anesthetics may also be at risk of sensitivity to levobupivacaine.Â
Patients with Porphyria: levobupivacaine use should be avoided in patients with known or suspected porphyria.Â
Pregnancy warnings:    Â
Pregnancy category: N/AÂ
Lactation: Excreted into human milk is unknownÂ
Pregnancy Categories:        Â
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.Â
<b>Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.  Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.  Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this category
Pharmacology:Â Â
levobupivacaine is categorized as a local anesthetic medication within the amide class of local anesthetics.Â
Pharmacodynamics:Â Â
like its other local anesthetics, levobupivacaine operates by obstructing sodium channels within nerve cell membranes. This action hinders the entry of sodium ions into nerve cells, subsequently impeding the initiation and transmission of nerve signals. Consequently, reversible local anesthesia and analgesia are achieved through this mechanism.Â
Pharmacokinetics:Â
AbsorptionÂ
levobupivacaine can be administered via various routes, including subcutaneous, epidural, and intravenous. It is absorbed relatively slowly, contributing to its longer duration of action compared to other local anesthetics.Â
DistributionÂ
levobupivacaine has a moderate volume of distribution and is highly protein-bound (approximately 97%), primarily to alpha-1-acid glycoprotein.Â
MetabolismÂ
levobupivacaine is metabolized in the liver through hepatic biotransformation involving cytochrome P450 enzymes, primarily the CYP3A4 isoenzyme. The metabolism is predominantly oxidative, resulting in the formation of various metabolites.Â
Excretion and EliminationÂ
The metabolites of levobupivacaine are primarily excreted in the urine. The elimination half-life of levobupivacaine is around 2.7 to 3.7 hours, but this can be longer in elderly patients due to reduced clearance.Â
Administration: Â
It is administered as infusion solution/injection.Â
Patient information leafletÂ
Generic Name: levobupivacaineÂ
Why do we use levobupivacaine? Â
Surgical Anesthesia: levobupivacaine is used to provide regional anesthesia during various surgical procedures. It can be administered through techniques such as epidural, spinal, and peripheral nerve blocks.Â
Labor Analgesia: levobupivacaine can be used for epidural analgesia during labor and childbirth, providing pain relief without causing significant motor block. This allows the mother to be comfortable while still being able to move her legs and participate in the birthing process.Â
Postoperative Pain Management: levobupivacaine can be used in the form of wound infiltration or continuous infusion through catheters to manage pain after surgery, reducing the need for systemic opioids and improving patient comfort.Â
Chronic Pain Management: In some cases of chronic pain, levobupivacaine can be used to perform nerve blocks or administer continuous infusion through implanted catheters to manage pain in conditions such as neuropathic pain and complex regional pain syndrome.Â
Â
Both our subscription plans include Free CME/CPD AMA PRA Category 1 credits.
On course completion, you will receive a full-sized presentation quality digital certificate.
A dynamic medical simulation platform designed to train healthcare professionals and students to effectively run code situations through an immersive hands-on experience in a live, interactive 3D environment.
When you have your licenses, certificates and CMEs in one place, it's easier to track your career growth. You can easily share these with hospitals as well, using your medtigo app.
