[Comparison of carbonated lidocaine and mepivacaine in epidural anesthesia]. 1994

F S Venuti, and M Curatolo, and T Mandolfino, and A Orlando
Istituto Pluridisciplinare di Anestesia, Rianimazione e Terapia Intensiva, Università degli Studi di Messina.

OBJECTIVE To compare carbonated mepivacaine to carbonated lidocaine in epidural anaesthesia. METHODS Nonrandomised control trial. METHODS University Hospital. METHODS Forty patients undergoing epidural anaesthesia for orthopaedic surgery. METHODS Epidural anaesthesia at the fourth lumbar interspace, administering either carbonated mepivacaine 20 ml (group M, 20 patients) or carbonated lidocaine 20 ml (group L, 20 patients). Parameters recorded: onset of sensory block (time required to reach L1 and time required to reach the upper level), cranial spread of analgesia (number of dermatomes), duration of block (time between achievement of maximum spread of analgesia and regression of sensory block by two dermatomes) and motor block (Bromage score). RESULTS No statistically significant differences have been found between group M and group L in the time required to reach L1 (means and standard deviations 6.3 +/- 3.8 and 6.5 +/- 2.1 minutes, respectively), in the time required to reach the upper level of analgesia (means and standard deviations 14.3 +/- 4.2 and 16.5 +/- 3.5 minutes, respectively), in the cranial spread of analgesia (means and standard deviations 7.1 +/- 3.4 and 7.6 +/- 2.7 dermatomes, respectively) and in the degree of motor block (means and standard deviations 1.5 +/- 0.8 and 1.1 +/- 0.8, respectively). Group M exhibited a much higher duration of sensory block, compared to group L (means and standard deviations 91.6 +/- 20.2 and 58.8 +/- 23.4 minutes, respectively, p < 0.001). CONCLUSIONS Carbonated mepivacaine is more indicated than carbonated lidocaine in epidural anaesthesia when a high duration of sensory block is desired.

UI MeSH Term Description Entries
D008012 Lidocaine A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE. Lignocaine,2-(Diethylamino)-N-(2,6-Dimethylphenyl)Acetamide,2-2EtN-2MePhAcN,Dalcaine,Lidocaine Carbonate,Lidocaine Carbonate (2:1),Lidocaine Hydrocarbonate,Lidocaine Hydrochloride,Lidocaine Monoacetate,Lidocaine Monohydrochloride,Lidocaine Monohydrochloride, Monohydrate,Lidocaine Sulfate (1:1),Octocaine,Xylesthesin,Xylocaine,Xylocitin,Xyloneural
D008619 Mepivacaine A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168) Carbocaine,Carbocaïne,Isocaine,Isogaine,Meaverin,Mecain,Mepihexal,Mepivacain-Injektopas,Mepivacaina Braun,Mepivacaine Hydrochloride,Mepivacaine Monohydrochloride,Mepivastesin,Polocaine,Scandicain,Scandicaine,Scandinibsa,Scandonest,Mepivacain Injektopas
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009985 Orthopedics A specialty which utilizes medical, surgical, and physical methods to treat and correct deformities, diseases, and injuries to the skeletal system, its articulations, and associated structures.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000767 Anesthesia, Epidural Procedure in which an anesthetic is injected into the epidural space. Anesthesia, Extradural,Anesthesia, Peridural,Epidural Anesthesia,Anesthesias, Epidural,Anesthesias, Extradural,Anesthesias, Peridural,Epidural Anesthesias,Extradural Anesthesia,Extradural Anesthesias,Peridural Anesthesia,Peridural Anesthesias
D015360 Analgesia, Epidural The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation. Epidural Analgesia

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