KEY FEATURES OF BUPIVACAINE TOXICITY
(i) More likely to result in cardiovascular collapse (CV collapse dose / dose for convulsions = 3.7 for bupivacaine and 7.1 for lidocaine).(ii) Ventricular arrhythmias are more likely to accompany cardiac toxicity (use bretylium).
(iii) Pregnant women are more sensitive to cardiac toxicity from bupivacaine.
(iv) Resuscitation is usually legthy.
(v) Toxicity is enhanced by acidosis and hypercarbia.