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there were no significant changes in the systolic blood pressures between 2% lidocaine group and 3% mepivacaine group (P>0.05). the average onset time was 111s. but there were significant changes in diastolic blood pressures and heart rate (P<0. ideal anesthetic effect and little side effect on cardiovascular system. which was similar to those of 2% lidocaine. 2% lidocaine with adrenaline in same cartridge was as control group and 3% mepivacaine was as the experimental group. the duration time was 212s and pain-free time was 134 min . Source Department of Endodontics. Abstract PURPOSE: To assess the efficacy and safety of 3% mepivacaine hydrochloride injection for oral local anesthesia. neural reaction and side effect of 2 groups were observed.nlm. Zhu YQ. Immediately after injection. 2008 Jun. Cao D. College of Stomatology.duration and pain-free time of 2 anaesthetics were examined. and post-operation.gov/pubmed/18661082 Shanghai Kou Qiang Yi Xue. RESULTS: In the mepivacaine group. Wu YN. Shanghai Jiao Tong University. The onset time. 5 minutes and 10 minutes after injection of anesthesia.ncbi.05).nih.http://www. Shanghai 200011. [Efficacy and safety of 3% mepivacaine hydrochloride injection for oral local anesthesia]. SAS software package was used for statistical analysis. Ninth People's Hospital. [Article in Chinese] Ding S.17(3):328-31. School of Medicine. . China. CONCLUSION: 3% mepivacaine has quick onset. The blood pressure and heart rate change. METHODS: 68 non-hypertension patients and 36 hypertension patients were randomly divided into 2 groups for local anesthesia.
Mean serum concentrations. and 60 minutes after mepivacaine injection. The volume of anesthetic injected depended on the planned procedures for each patient. 45. Abstract The authors measured plasma concentrations of mepivacaine in 36 children from the ages of 2 to 5 years who received dental care under light general anesthesia. 30.002) on a volume basis.000 levonordefrin or 3 percent mepivacaine hydrochloride without vasoconstrictor.0. 20. However. . Source UCLA School of Dentistry.SD) after 3 percent mepivacaine and 0.0. Henderson KR.5 times as toxic (P < 0. The subjects were randomly assigned to receive either 2 percent mepivacaine hydrochloride with 1:20. 10. Duperon DF.J Calif Dent Assoc. UCLA. Statistical analysis also suggested that the maximum recommended dose of 3 mg/lb could result in potentially toxic blood concentrations in a small percentage of pediatric patients. Levonordefrin had no significant effect on the plasma concentrations. Serum mepivacaine concentrations after intraoral injection in young children.42 microgram/mL (mean +/.31(10):757-64. The serum was collected and analyzed by gas-liquid chromatography. Yagiela JA. 2003 Oct.63 +/. USA. reached a peak of 0. Quinn CL. The authors conclude that 3 percent mepivacaine should not be used when relatively large volumes of local anesthetic must be administered to small children and recommend that the maximum dose of mepivacaine not exceed 5 mg/kg. normalized to a dose of 1 mg/kg body weight.21 microgram/mL after 2 percent mepivacaine with levonordefrin. David Geffen School of Medicine. because of the higher concentration of mepivacaine in the 3 percent formulation. Chin KL.67 +/. it was potentially 1. Blood samples (3 mL) were drawn from an intravenous line before and 5.
lidocaine and tetracaine. 5 x 10(-5) M for tetracaine. bupivacaine and lidocaine. has the least-adverse effects on cone growth among clinically used local anesthetics. binjik@post1.Anesth Analg. which has a similar pharmacological effect to lidocaine. mepivacaine. and dibucaine by using cultured neurons from the freshwater snail Lymnaea stagnalis. Takasaki M. Kasaba T. lidocaine. Kiyotake-Cho. We compared the neurotoxicity of procaine. which has a similar pharmacological effect to lidocaine. table of contents. The order of neurotoxicity was procaine = mepivacaine < ropivacaine = bupivacaine < lidocaine < tetracaine < dibucaine. 2003 Jul. The median concentrations yielding a score of 1 were 5 x 10(-4) M for procaine. Procaine and mepivacaine have less toxicity in vitro than other clinically used local anesthetics.05) were observed between mepivacaine and ropivacaine. bupivacaine.97(1):85-90. tetracaine. IMPLICATIONS: Systematic comparison was assessed morphologically in growth cones and neurites exposed to seven local anesthetics.miyazakimed. ropivacaine. Although lidocaine is more toxic than bupivacaine and ropivacaine. A solution of local anesthetics was added to the culture dish to make final concentrations ranging from 1 x 10(-6) to 2 x 10(-2) M. mepivacaine. 1 x 10(-4) M for lidocaine. and 2 x 10(-5) M for dibucaine. Source Department of Anesthesiology. Japan.jp Abstract The neurotoxicity of local anesthetics can be demonstrated in vitro by the collapse of growth cones and neurites in cultured neurons.ac. Although lidocaine is more toxic than bupivacaine and ropivacaine. and tetracaine and dibucaine. 2 x 10(-4) M for bupivacaine. . 5 x 10(-4) M for mepivacaine. 2 x 10(-4) M for ropivacaine. Morphological changes in the growth cones and neurites were observed and graded 1 (moderate) or 2 (severe). Statistically significant differences (P < 0. The order of neurotoxicity was procaine = mepivacaine < ropivacaine = bupivacaine < lidocaine < tetracaine < dibucaine. mepivacaine. is the safest among clinically used local anesthetics. Miyazaki Medical College. Onizuka S.
http://www. very close to lidocaine. intermediate duration and low toxicity. Italy. De Tommaso O. 2001 Sep. particularly in high cardiac risk patients.nlm. Clinically. and its rapid excretion via the kidneys. Pharmacologic features of mepivacaine are: its amide structure (therefore it is not detoxified by circulating plasma esterases). its rapid metabolism. Rome.67(9 Suppl 1):5-8. Source Department of Anaesthesia and ICU. PMID: 11778086 [PubMed . since serious complications can be related to local anaesthetics administration. Abstract Many local anaesthetics are presently available for clinical use. Mepivacaine: update on an evergreen local anaesthetic.ncbi. which take place into the liver. mepivacaine shows: short onset time. Caporuscio A. Mepivacaine can be therefore considered as a first choice agent for peripheral nerve blocks. Besides these. The choice of a particular agent for a particular regional anaesthetic is based mainly on its clinical and pharmacological features. S.indexed for MEDLINE] . Tagariello V.gov/pubmed/11778086 Minerva Anestesiol. Pietro FBF General Hospital. safety of drugs and the knowledge of side effects associated with their use can play a major role.nih.
The 3% mepivacaine had a minimal effect on heart rate and would be useful in patients with contraindications to epinephrine use.8 mL of 3% mepivacaine) + intraosseous injection with 1. when used to augment an inferior alveolar nerve block. Abstract OBJECTIVE: The purpose of this study was to determine the anesthetic efficacy and heart rate effects of an intraosseous injection of 3% mepivacaine after an inferior alveolar nerve block. each of 48 subjects randomly received 2 combinations of injections at 2 separate appointments. CONCLUSIONS: The intraosseous injection of 1. STUDY DESIGN: Through use of a repeated-measures design. Anesthetic efficacy and heart rate effects of the intraosseous injection of 3% mepivacaine after an inferior alveolar nerve block. Heart rate (pulse rate) was measured with a pulse oximeter.8 mL of 3% mepivacaine. Nist R. The first molar was blindly pulp tested at 2-minute cycles for 60 minutes postinjection. 8 mL of 3% mepivacaine) + mock intraosseous injection.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Source Division of Endodontics. Stabile P. 2000 Jan. The Ohio State University. Columbus 43210. Anesthetic success for the first molar was significantly increased for 30 minutes with intraosseous injection of mepivacaine in comparison with the inferior alveolar nerve block alone (mock intraosseous injection). Subjects receiving the intraosseous injection of mepivacaine experienced minimal increases in heart rate. The combinations were (1) an inferior alveolar nerve block (with 1. Beck M. USA. Anesthesia was considered successful with 2 consecutive 80 readings. Gallatin E.8 mL of 3% mepivacaine and (2) an inferior alveolar nerve (with 1. Reader A. RESULTS: All subjects had lip numbness with both of the inferior alveolar nerve + intraosseous techniques. significantly increased anesthetic success for 30 minutes in the first molar.89(1):83-7. .
o. injection of 3 percent mepivacaine.o. The purpose of this study was to determine the cardiovascular effects of an i. RESULTS: With the 2 percent lidocaine with 1:100. injection. Nist R. injection of the 2 percent lidocaine-epinephrine solution experienced a transient increase in heart rate. Weaver J. METHODS: With the use of a repeated-measures design.o. 28 (67 percent) of 42 subjects experienced an increase in heart rate that might be attributed to the effect of the epinephrine. Abstract BACKGROUND: Because a number of patients have reported an increase in heart rate with the intraosseous. In patients whose medical condition. At each appointment the authors monitored electrocardiographic findings.8 mL of 3 percent mepivacaine in a double-blinded manner at two appointments. No significant increase in heart rate was seen with the i. Ohio State University.000 epinephrine and 3 percent mepivacaine. mean systolic or mean arterial blood pressure values between the subjects receiving 2 percent lidocaine with 1:100.J Am Dent Assoc. In 22 (79 percent) of these subjects. Meyers WJ. or i. it is important to evaluate changes in the cardiovascular system with this injection technique. systolic and diastolic blood pressure. No significant differences (P > . Source Graduate Endodontics.000 epinephrine or 1. The authors found no significant increase in heart rate in subjects receiving the 3 percent mepivacaine. cardiac rate. during and after administration of anesthetic solutions. Cardiovascular effects of intraosseous injections of 2 percent lidocaine with 1:100.o. CLINICAL IMPLICATIONS: While patients would likely notice the heart rate increase with the lidocaine-epinephrine solution. . the heart rate returned to within 5 beats of baseline values within four minutes after solution deposition.o. 3 percent mepivacaine is a good alternative for i. drug therapies or epinephrine sensitivity suggests caution.o.000 epinephrine and 3 percent mepivacaine. it would not be clinically significant in most healthy patients. Beck M. and mean arterial pressure before.8 milliliters of 2 percent lidocaine with 1:100.000 epinephrine and those receiving 3 percent mepivacaine.130(5):649-57. the authors randomly assigned 42 subjects to receive i. Reader A. Replogle K. Columbus 43210. USA. 1999 May. injection of 2 percent lidocaine with 1:100. injections..05) were found in mean diastolic.000 epinephrine solution. CONCLUSIONS: The majority of subjects receiving the i. injections of 1.
STUDY DESIGN: Forty-eight patients with irreversible pulpitis received conventional inferior alveolar nerve blocks. A second intraosseous injection of 3% mepivacaine (1. the first intraosseous injection increased success to 80%. Reader A. subjective heart rate increase. Patients who were positive to the pulp testing. Reisman D. Source Ohio State University. . USA. Electric pulp testing was used to determine pulpal anesthesia. a supplemental intraosseous injection of 3% mepivacaine increased anesthetic success. further improved success. RESULTS: Seventy-five percent of patients required an initial intraosseous injection because of failure to gain pulpal anesthesia. Intraosseous injection pain.8 ml) was given if the first injection was unsuccessful. Columbus. Eight percent (4/48) of the initial intraosseous injections resulted in solution being expressed into the oral cavity: these were considered technique failures. Weaver J.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. The inferior alveolar block was 25% successful. or negative to pulp testing but felt pain during endodontic treatment. Beck M. CONCLUSIONS: For mandibular posterior teeth with irreversible pulpitis.84(6):676-82. A second intraosseous injection further increased success to 98%. 1997 Dec.8 ml of 3% mepivacaine. Abstract OBJECTIVE: To determine the efficacy of a supplemental intraosseous injection of 3% mepivacaine in mandibular posterior teeth with irreversible pulpitis. and pain ratings during endodontic treatment were also assessed. received an intraosseous injection of 1. Nist R. These differences were significant (p < 0. A second intraosseous injection. Anesthetic efficacy of the supplemental intraosseous injection of 3% mepivacaine in irreversible pulpitis. when necessary.05).
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