Mepivacaine, injectable

Vasoconstrictor substances such as epinephrine reduce systemic absorption of local anesthetics from the injection site by decreasing blood flow in these areas. This is important for drugs with intermediate or short durations of action such as procaine, lidocaine, and mepivacaine (but not prilocaine). 

Basson (1978), Basson Carlson (1980) described myotoxicity after single and repeated injections of mepivacaine in the rat. Young rats received single or repeated injections of 2% mepivacaine into the tibialis anterior or extensor digitorum longus muscles. Repeated injections consisted of 6 injections of the anesthetic (100 il per injection into the tibialis anterior) on different schedules, at intervals of 21/2 hours, 24 hours, or 4 days. The muscles were examined histologically for evidence of myotoxicity at 0 to 7 and 20 days after the last injection. Single injections showed that mepivacaine is a myotoxic... 

Basson MD (1978) Effects of multiple mepivacaine (Carbocain) injections on rat skeletal muscle. Clin Res 26 730A Basson MD, Carlson BM (1980) Myotoxicity of single and repeated injections of mepivacaine (Carbocain) in the rat. Anesth Analg 59 275-282... 

Dose. Mepivacaine hydrochloride is given by injection in doses of up to 400 mg maximum of 1 g in 24 hours. 

Two to three injection sites may be needed to provide adequate anesthesia. For minor surgical procedures of the eyelid, the volume of anesthetic required would be far less than the maximum dose of most local anesthetics (e.g., procaine, lidocaine, and mepivacaine)—approximately 500 mg as a 1% or 2% solution.A ring block or field block may be used to anesthetize around the area of the surgical site in a circumferential manner without injecting... 

Injection directly into the cerebrospinal fluid (CFS) ensures complete CNS bioavailability for drugs that cannot cross the blood-brain barrier. This dosage route is used to treat serious CNS infections such as meningitis and ventriculitis, and with such agents as mepivacaine and prilocaine for spinal anesthesia. Drugs injected intrathecally initially distribute into approximately 140 ml of CSF, thus producing high concentrations in the CNS with low risk of systemic toxicity. 

Presentation Transient radicular irritation causes transient pain in the back, buttocks, and lower extremities, without formal neurological signs or symptoms. It can follow single-dose intrathecal anesthesia. Lidocaine has been reported as the predominant culprit. However, transient radicular irritation has also been reported with bupivacaine, mepivacaine, tetracaine, and prilocaine. Osmolarity, the addition of dextrose, and speed of injection do not contribute, and even reducing the concentration of hdocaine does not alter the incidence (220,221). 

A 46-year-old woman had an epidural placed at L4/5 (259). As there was insufficient block 20 minutes after injection of 300 mg mepivacaine, the epidural catheter was removed and an intrathecal injection of 0.5% tetracaine 2 ml dissolved in 5% glucose was performed. She was then placed in the hthotomy position for 30 minutes. One day postoperatively she developed pain and numbness in her left leg, and the numbness spread to the lower back, buttocks, and thighs. The symptoms disappeared after 4 days. 

The endothelial toxicity of local anesthetics has been assessed in pigs, as this might be relevant to the safety of agents given by intracameral injection (335). Lidocaine, mepivacaine, and prilocaine were safe, while bupivacaine in clinically effective concentrations resulted in significant cell reduction. 

Two cases of transient blindness after subconjunctival injection of 2% mepivacaine 2 ml were reported in patients with advanced refractory glaucoma undergoing diode laser cyclophotocoagulation (339). The authors hypothesized that in patients with advanced optic neuropathy, even subconjunctival anesthesia can result in optic nerve block. 

Specht T E, Nixon A J, Moyer D J 1988 Equine synovia after an intraarticular Injection of lidocaine or mepivacaine. Veterinary Surgery 17 42-49... 

Mepirzapin mirtazapine. mepitiostane [inn, jan] (S i0364) is a steroid with anabolic and antioestrogen activity. It has been used as an oral ANTICANCER AGENT for breast cancer, mepivacaine [ban. inn] (meplvacalne hydrochloride [usan] Carbocaine Polocaine Scandonest ) is an ester series LOCAL ANAESTHETIC with a rapid onset and intermediate duration of action. It is used by injection for infiltration, dental, regional and epidural pain relief and motor block, mepivacaine hydrochioride mepivacaine. mepixanox [inn] is a cm stimulant and respiratory... 

Plasma samples of 1.0 ml were alkalinized (NaOH), the internal standard (mepivacaine) added and the mixture extracted with chloroform. The chloroform solution was evaporated and the residue redissolved in methanol (25 yl). 1.5 yl of the methanol solution was injected for the gas chromatographic analysis on a packed column of 3 % OV-17 on Chromosorb P. A typical chromatogram is given in Figure 20.5. Peak height ratio measurements produced linear standard curves in the 0.25-10.0 yg/ml range. Absolute sensitivity from a 1.0 ml plasma sample was 0.1 yg/ml. The relative deviation of a 2.0 yg/ml pooled plasma standard curve (done repeatedly over several months) was 5.2 5 . 

Sample preparation Dilute with water to a concentration of 125 p.g/mL, add a 30t) jlL aliquot to 250 jjlL 2 mg/mL mepivacaine hydrochloride in water, vortex, inject a 10 jjlL aliquot. 

Giaufre E, Bruguerolle B, Morisson-Lacombe G, Rousset-Rouviere B. Influence of midazolam on the plasma concentrations of mepivacaine after lumbar epidural injection in children. 

Skin Linear scleroderma occurred after injection of mepivacaine into the dorsum of the foot in a 36-year-old woman and progressed in extent and severity over 3 years there were multiple linear sclerotic plaques on the leg, the distribution of which was consistent with Blaschko lines [TO ]. 

Ueda T, Niiyama S, Amoh Y, Katsuoka K. Linear scleroderma after contusion and injection of mepivacaine hydrochloride. Dermatol Online J 2010 16 11. 

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