Most Cardio toxic local anaesthetic is?
Correct Answer: Bupivacaine
Description: ANSWER: (B) BupivacaineREF: Miller 5th ed p. 586, Local Anesthesia in dentistry By Paul D, Robinson, Fraser McDonald, Thomas R. Pitt Fordt T. R. Pitt For page 75Bupivacaine:Most cardiotoxic and long acting amideMost potent and best agent for isobaric and spinal AnesthesiaContraindicated in IV Anesthesia due to cardiotoxicityUsed for intradural and epidural and peripheral blocks"Bupivacaine is the most cardio toxic of all local anaesthetic and is contraindicated in pregnancyNote:All local anaesthetic crosses placenta to some extent.Prilocaine crosses placenta most readilyBupivacaine crosses placenta least readily but since it is most cardio toxic, it is contraindicated in pregnancy.Also know:Shortest acting LA- ChlorprocaineContraindicated in intradural due to paraplegia - ChlorprocaineLongest acting LA - DibucaineNatural LA- cocaineOnly vasoconstrictor LA- Cocaine << Vasoineffective LA- LignocaineLA of choice in NMS- ProcaineContraindicated in neonates and labor- Mepivacaine
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