Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials

Tan, Haifeng; Wan, Teng; Guo, Weiming; Fan, Gang; Xie, Yu

doi:10.1007/s12325-022-02088-3

Cited by 3 publications

(3 citation statements)

References 39 publications

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“…However, mepivacaine also had higher incidences of transient neurologic symptoms and transient nerve root irritation than bupivacaine. There was no significant difference in pain scores or distance walked after surgery despite early ambulation with mepivacaine [107,108].…”

Section: Mepivacainementioning

confidence: 80%

“…Mepivacaine is an intermediate-acting local anesthetic with a shorter duration at around 1.5-2 h. Review articles of RCTs and retrospective cohort studies have compared mepivacaine and bupivacaine for spinal anesthesia in total hip arthroplasty and total knee arthroplasty [107,108]. The results found that mepivacaine treatment is associated with higher incidence of complete motor blocks, shorter hospital stay, faster resolution of the motor block, sooner return to normal voiding function, and earlier time to ambulation compared to bupivacaine.…”

Section: Mepivacainementioning

confidence: 99%

See 1 more Smart Citation

Novel Techniques and Local Anesthetics for Perioperative Pain Management

Wang,

Kerolus,

Garry

et al. 2023

Advances in Regional Anesthesia - Future Directions in the Use of Regional Anesthesia

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Careful perioperative pain management is crucial for good patient outcomes after surgery, as poorly controlled pain interferes with the ability of patients to recover to normal baseline function and increases postoperative morbidity and mortality. Although opioids have been the mainstay for treating postoperative pain, there has been a shift in favor of a multimodal analgesic approach, including regional anesthesia, as a way to circumvent opioid-related adverse events (e.g. nausea and vomiting, respiratory depression, sedation). In this chapter, we present an update on several recently developed regional anesthetic techniques, local anesthetic medications, as well as nerve block adjuncts with the potential to improve pain management in the perioperative setting. With more future studies, these novel methods may be incorporated into postsurgical recovery protocols and provide the opportunity to improve patient outcomes.

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Section: Mepivacainementioning

confidence: 80%

Section: Mepivacainementioning

confidence: 99%

Novel Techniques and Local Anesthetics for Perioperative Pain Management

Wang,

Kerolus,

Garry

et al. 2023

Advances in Regional Anesthesia - Future Directions in the Use of Regional Anesthesia

View full text Add to dashboard Cite

show abstract

“…It is reported to be the most myotoxic local anesthetic available and is associated with notable cardiotoxic and neurotoxic effects. [5][6][7] Existing medical literature has explored intravenous lipid emulsions and cerebrospinal fluid (CSF) exchange as potential strategies to counteract the undesirable effects of a high or total spinal block. Although the symptoms of sympathectomy manifest rapidly, current treatment approaches tend to be limited in their application and often exhibit a delayed onset of action.…”

Section: Introductionmentioning

confidence: 99%

Rat Model: Intrathecal Lipid for Total Spinal BlockInduced Hemodynamic Instability

Darçın

2023

J Clin Pract Res

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Objective: This study aimed to assess the potential of intrathecal administration of lipid emulsions as a targeted therapeutic strategy to mitigate the hemodynamic consequences of high or total spinal anesthesia induced by bupivacaine in a rat model. Materials and Methods: After receiving approval from Koç University's Local Ethics Board of Animal Experiments, 14 adult female Wistar Albino rats were randomized into two groups: Lipid and Saline. After inducing a high spinal block, each group was treated with either intrathecal lipid emulsions or isotonic saline solutions, respectively. Hemodynamic parameters such as systolic, diastolic, and mean arterial blood pressures, as well as heart rate, were continuously monitored. A histological analysis was conducted upon completion of the study. Results:The Lipid group exhibited a significant increase in mean systolic (p=0.002), diastolic (p=0.002), and arterial pressures (p=0.002) compared to the Saline group. The mean pulse rate also differed significantly between the groups (p=0.009). Notably, while all rats in the Saline group succumbed, only two fatalities occurred in the Lipid group, with the other five rats surviving (p=0.021). Conclusion:This study suggests that intrathecal administration of lipid emulsions can serve as a rapid and effective intervention to counteract the hypotension and bradycardia induced by high or total spinal anesthesia with bupivacaine in rats. While these findings are promising, further experimentation and clinical trials are required to confirm this method's potential, focusing on its long-term safety, efficacy, and the establishment of an optimal administration protoco.

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Mepivacaine dosing for spinal anesthesia in pediatric orthopedic surgery: a retrospective chart review

Carley,

Sheetz,

Lauzadis

et al. 2024

Reg Anesth Pain Med

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BackgroundMepivacaine is an intermediate-acting local anesthetic used for spinal anesthesia in adults. Currently, there are no published dosing guidelines for spinal mepivacaine in patients under age 18.AimsThe purpose of this study is to describe the clinically used doses of mepivacaine by weight and age for orthopedic surgery in pediatrics.MethodsWe performed a retrospective chart review of patients aged 0–18 who received mepivacaine for spinal anesthesia from 2016 to 2022. We performed a secondary analysis for patients aged 0–18 who received spinal anesthesia with bupivacaine or chloroprocaine.ResultsThe data extraction yielded 3627 single-shot mepivacaine spinals. Patient age ranged from 5 to 18 years. Median dosage in milligrams/kilograms (mg/kg) of mepivacaine was calculated for each age group. Our analysis revealed that dosage in mg/kg decreased by patient age and began to plateau at age 15. Bupivacaine was the most common single-shot spinal agent in patients under age 10. After age 10, mepivacaine was more common. Chloroprocaine began to be used in patients older than 8 years.ConclusionsWe describe mepivacaine dosage as a function of age and weight in patients younger than 18 years. As age and weight increased, a lower dose of mepivacaine per kg was administered for spinal anesthesia.

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Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials

Cited by 3 publications

References 39 publications

Novel Techniques and Local Anesthetics for Perioperative Pain Management

Novel Techniques and Local Anesthetics for Perioperative Pain Management

Rat Model: Intrathecal Lipid for Total Spinal BlockInduced Hemodynamic Instability

Mepivacaine dosing for spinal anesthesia in pediatric orthopedic surgery: a retrospective chart review

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