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Discussion on how to represent hyperbaric bupivacaine in SNOMED

Contributors (2)


  1. Steven Dain

    Grant, regarding 1, I suggest adding bupivacaine 0.75% with Glucose 7.5% as a product

    regarding 2, I would use the existing "surgical time out procedure code"

    regarding 3, I'll have a look later 4 surgic15682000 | Surgical time out (procedure) |

    1. Grant Forrest

      Thanks Steven, re. 1, that would certainly work, but my understanding is that  Hyperbaric bupivacaine can also be produced by the addition of glucose (80 mg.ml−1) to isobaric (‘plain’) bupivacaine 0.5%, which would be 8%. No doubt other preparations exist. Give the variety of units used and preparations, I think what I was saying is that there may be a need to express the concept of 'baricity' without reference to pharmaceutical preparations, but I'm not sure how that could be done.
      Should we move this to 'discussions' ?

  2. Hi Grant, would need some advice from Monica Harry on how SNOMED deals with products that conduct more than one active ingredient.  I had forgotten that different countries use different concentrations of glucose.  The one in Canada is premixed Bupivacaine 0.75% /Glucose 7.5%.

  3. Hi Steven Dain and Grant Forrest

    The International Release includes sufficiently defined Clinical drug concepts with >1 active ingredient (e.g. 408035004 |Product containing precisely bupivacaine hydrochloride 2.5 milligram/1 milliliter and epinephrine (as epinephrine bitartrate) 5 microgram/1 milliliter conventional release solution for injection (clinical drug)|). More specific concepts, such as those that would indicate the solution is available in a 5 mL vial, a box of 10 x 5 mL vials, or concepts with a specific brand/trade name, would be modeled in a national extension or local medicinal product dictionary.

    If the bupivacaine-glucose product you are discussing is manufactured as a premixed solution, I expect it could be modeled similarly to the bupivacaine-epi example above, reflecting whatever strengths are available. If it is a product that is provided as separate components (e.g. an ampule of bupivicaine and an ampule of glucose) to mixed by the clinician, then the individual components could be included in the International Release but the package containing both components would be in a national extension or local medicinal product dictionary.

    We do not currently describe medicinal products based on baracity as was not a use case or requirement identified for consideration when we developed the Medicinal product concept model and editorial guidelines several years ago.

    I hope this helps answer your questions; please let me know if you need any further information.


    cc: Monica Harry