Mepivacaine Hydrochloride Injection

What is Mepivacaine Hydrochloride Injection?
Mepivacaine Hydrochloride Injection is an amide-type local anesthetic with an intermediate duration of action. It is chemically related to Bupivacaine but has a faster onset. It is unique among local anesthetics because it possesses mild vasoconstrictive properties, which often allows it to be used without the addition of epinephrine (adrenaline). This makes it the preferred anesthetic for patients for whom epinephrine is contraindicated, such as those with severe hypertension or cardiovascular disease.
Uses of Mepivacaine Hydrochloride Injection
Dental Anesthesia: Widely used for infiltration and nerve blocks in dentistry, particularly for short procedures.
Peripheral Nerve Blocks: Anesthesia of specific nerve groups (e.g., brachial plexus, intercostal) for upper and lower limb surgeries.
Infiltration Anesthesia: Local numbing for minor surgical procedures and wound suturing.
Epidural & Caudal Block: Used in obstetric and surgical settings to provide regional anesthesia.
Specialized Surgery: Often utilized in ophthalmic and ENT procedures where localized control is required.
How Does Mepivacaine Hydrochloride Injection Work?
Mepivacaine works by stabilizing the neuronal membrane. It binds to and inhibits voltage-gated sodium channels on the internal surface of nerve cell membranes. This prevents the influx of sodium ions, which is essential for the generation and conduction of nerve impulses. By "blocking" these electrical signals, the transmission of pain to the central nervous system is effectively halted. Its mild vasoconstrictive effect helps keep the medication at the injection site longer, extending the duration of the block without needing secondary drugs.
FAQs on Mepivacaine Hydrochloride Injection
1. How long does the numbing effect of Mepivacaine last? The duration varies by the site of injection, but it generally provides anesthesia for 2 to 3 hours. When used for dental procedures, the pulpal (tooth) anesthesia typically lasts about 20–40 minutes, while soft tissue anesthesia can last up to 2–3 hours.
2. Why is it often used without Epinephrine? Mepivacaine naturally causes less vasodilation (widening of blood vessels) than Lidocaine. Because it doesn't "wash away" from the injection site as quickly, it provides an adequate duration of action on its own. This is a significant benefit for patients with heart conditions who might react poorly to the adrenaline found in other anesthetics.
3. Is Mepivacaine safe for all patients? While generally well-tolerated, it is metabolized by the liver. Therefore, it should be used with caution in patients with significant hepatic impairment. As with all local anesthetics, vital signs must be monitored to prevent systemic toxicity (LAST - Local Anesthetic Systemic Toxicity).
Therapeutic Category
Anesthetics (Local/Regional Anesthetic - Amide type)
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