Boxed Warning (Boxed Warning)
The use of Bupivacaine Hydrochloride with 0.75% concentration is not recommended for obstetrical anesthesia due to reports of cardiac arrest and death. It is suggested that this concentration be reserved for surgical procedures where muscle relaxation and prolonged effect are necessary. In most cases, there have been difficulties in resuscitation even with adequate preparation and appropriate management. Cardiac arrest has occurred following convulsions resulting from systemic toxicity, presumably from unintentional intravascular injection.*