Mepivacaine (Carbocaine, Isocaine, Polocaine)

Category:

  • Local anesthetic

Description:

  • Local anesthetic

Indications:

  • Nerve block, caudal anesthesia, epidural anesthesia

  • Pain relief, paracervical block in obstetrics, transvaginal block

  • Soft tissue infiltration anesthesia, anesthesia of dental procedures

Contraindications:

  • Heart block (large doses)

  • Septicemia (spinal anesthesia)

Precautions:

  • Pregnancy category C

  • Hepatic disease, use in head and neck, children, inflammation

  • Sepsis, elderly, neurologic disease, spinal deformaties

  • Impaired cardiovascular function, renal disease

  • Hypertension (epidural and caudal anesthesia)

Adverse Reactions (Side Effects):

  • CNS: anxiety, disorientation, loss of consciousness, seizures, shivers, tremors

  • CV: bradycardia, cardiac arrest, dysrhythmias, fetal bradycardia, myocardial depression, hypotension, hypertension

  • RESP: anaphylaxis, respiratory arrest

  • SKIN: allergic reactions, burning, skin discoloration at injection site, tissue necrosis

Dosage:

Administered via injection

  • Adult:  Dose varies with type of procedure, degree of anesthesia required, and individual response; max amount given per procedure should not exceed 400mg; total dose per 24 hours should not exceed 1g

    • Nerve block: 

      • 1% or 2% solution

    • Paracervical block: 

      • 1% solution

    • Transvaginal block: 

      • 1% solution

    • Caudal and epidural block: 

      • 1%, 1.5%, or 2% solution

    • Infiltration: 

      • 1% solution

    • Dental procedures: 

      • 3% solution

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