A long-acting amino-amide local anaesthetic agent. Its clinical potency and its duration of action is approximately four times that of lignocaine. It is commonly used as the anaesthetic agent in epidurals and spinal anaesthesia and after surgical procedures. It is available with or without adrenaline and is significantly more cardiotoxic than other local anaesthetics. Inadvertent intravenous injection can lead to hypotension, bradycardia, arrhythmias, and cardiac arrest. Levobupivacaine is the pure R-isomer of bupivacaine and is less cardiotoxic.