A 28-year-old female opts for painless labor. On administration of the epidural anesthetic, there is a sudden drop in the blood pressure. The reason for this was found to be accidental intravenous injection of the anesthetic drug. Which of the following drugs is the most likely responsible for the present condition?

Answer: d) BupivacaineBupivacaineBupivacaine is typically used in painless labor.It is long-acting and an amide local anesthetic.It is injected outside the duramater.The most important complication is accidental intravenous administration of the drug.This can be prevented by slow administration in 3-5 mL increments gradually to watch out for the side effects related to intravenous administration.Bupivacaine binds to the sodium channels more strongly, especially those in the bundle of His, when compared to local anesthetics.This can result in significant cardiac arrhythmias, which present as palpitations and hypotension.Concentrations of 0.125 % and 0.25 % are used in painless labor; 0.75 % is absolutely contraindicated because of cardiovascular adverse effects.