Biomaterial Database

Unusually prolonged duration of spinal anesthesia following 2% mepivacaine. 1998

V Tagariello, and L Bertini

Servizio di Anestesia e Rianimazione, Centro Ortopedico Traumatologico, Rome, Italy.

OBJECTIVE Spinal mepivacaine has been reported as a reliable anesthetic for ambulatory anesthesia. Its pharmacologic properties are midway between those of bupivacaine and lidocaine, and it can be used in intermediate duration ambulatory surgical procedures. METHODS A patient taking clonidine transdermal patches (TTS) to control high blood pressure received spinal mepivacaine for surgical repair of a ruptured meniscus with arthroscopy. RESULTS The resulting duration of sensory and motor block were 12 and 8.5 hours, respectively. These are more than four times as long as the reported mean durations with this spinal local anesthetic. We hypothesized that the use of clonidine via TTS for the previous 16 months contributed to this unusual delay of recovery from spinal anesthesia. CONCLUSIONS Clonidine can increase the duration of spinal anesthetics. Even though this well-known effect has been considered mostly beneficial, it can be an adverse effect when spinal ambulatory anesthesia is given to patients receiving clonidine TTS or clonidine in other forms for long-term treatment of hypertension or other diseases.

UI	MeSH Term	Description	Entries
D008297	Male		Males
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
D003000	Clonidine	An imidazoline sympatholytic agent that stimulates ALPHA-2 ADRENERGIC RECEPTORS and central IMIDAZOLINE RECEPTORS. It is commonly used in the management of HYPERTENSION.	Catapres,Catapresan,Catapressan,Chlophazolin,Clofelin,Clofenil,Clonidine Dihydrochloride,Clonidine Hydrochloride,Clonidine Monohydrobromide,Clonidine Monohydrochloride,Clopheline,Dixarit,Gemiton,Hemiton,Isoglaucon,Klofelin,Klofenil,M-5041T,ST-155,Dihydrochloride, Clonidine,Hydrochloride, Clonidine,M 5041T,M5041T,Monohydrobromide, Clonidine,Monohydrochloride, Clonidine,ST 155,ST155
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000279	Administration, Cutaneous	The application of suitable drug dosage forms to the skin for either local or systemic effects.	Cutaneous Drug Administration,Dermal Drug Administration,Drug Administration, Dermal,Percutaneous Administration,Skin Drug Administration,Transcutaneous Administration,Transdermal Administration,Administration, Dermal,Administration, Transcutaneous,Administration, Transdermal,Cutaneous Administration,Cutaneous Administration, Drug,Dermal Administration,Drug Administration, Cutaneous,Skin Administration, Drug,Administration, Cutaneous Drug,Administration, Dermal Drug,Administration, Percutaneous,Administrations, Cutaneous,Administrations, Cutaneous Drug,Administrations, Dermal,Administrations, Dermal Drug,Administrations, Percutaneous,Administrations, Transcutaneous,Administrations, Transdermal,Cutaneous Administrations,Cutaneous Administrations, Drug,Cutaneous Drug Administrations,Dermal Administrations,Dermal Drug Administrations,Drug Administrations, Cutaneous,Drug Administrations, Dermal,Drug Skin Administrations,Percutaneous Administrations,Skin Administrations, Drug,Skin Drug Administrations,Transcutaneous Administrations,Transdermal Administrations
D000556	Ambulatory Surgical Procedures	Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.	Ambulatory Surgery,Day Surgery,Office Surgery,Outpatient Surgery,Surgery, Office,Surgery, Outpatient,Ambulatory Surgical Procedure,Procedure, Ambulatory Surgical,Procedures, Ambulatory Surgical,Surgery, Ambulatory,Surgery, Day,Surgical Procedure, Ambulatory,Surgical Procedures, Ambulatory,Ambulatory Surgeries,Day Surgeries,Office Surgeries,Outpatient Surgeries,Surgeries, Ambulatory,Surgeries, Day,Surgeries, Office,Surgeries, Outpatient
D000762	Anesthesia Recovery Period	The period of emergence from general anesthesia, where different elements of consciousness return at different rates.	Recovery Period, Anesthesia,Anesthesia Recovery Periods,Period, Anesthesia Recovery,Periods, Anesthesia Recovery,Recovery Periods, Anesthesia
D000775	Anesthesia, Spinal	Procedure in which an anesthetic is injected directly into the spinal cord.	Anesthesias, Spinal,Spinal Anesthesia,Spinal Anesthesias
D000779	Anesthetics, Local	Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.	Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics