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The anesthetic and recovery profile of two doses ( 60 and 80 mg ) of plain mepivacaine for ambulatory spinal anesthesia . UNLABELLED Reports of transient neurological symptoms with the use of subarachnoid lidocaine has generated interest in alternate local anesthetics of intermediate duration , such as mepivacaine . This prospective randomized , double-blinded , dose-response study examined the anesthetic and recovery profiles of 60- and 80-mg doses of preservative-free plain mepivacaine for ambulatory spinal anesthesia . Sixty patients undergoing ambulatory anterior cruciate ligament repair of the knee under spinal anesthesia were randomized into two groups ; Group 1 ( 29 patients ) received 4 mL of 1.5 % ( 60-mg dose ) and Group 2 ( 31 patients ) received 4 mL of 2 % ( 80-mg dose ) of plain mepivacaine . All patients received a combined spinal-epidural anesthetic technique . The epidural catheter was used only in the event the surgery outlasted the duration of surgical anesthesia with subarachnoid mepivacaine . Epidural supplementation was administered in three patients ( 12 % ) in Group 1 and one patient ( 3 % ) in Group 2 when the sensory block regressed to L-1 with surgery expected to last longer than 15 min . The cephalad dermatome level of the block and degree of motor block was comparable in the two groups . Times to two-segment and T-10 regression were comparable in the two groups ( 112 +/- 26 min in Group 1 versus 122 +/- 28 min in Group 2 ) . Time to L-1 regression was significantly longer in Group 2 ( 146 +/- 28 min in Group 1 versus 159 +/- 19 min in Group 2 ) . All of the ambulatory milestones were significantly faster in Group 1 . Side effects , such as hypotension and emesis were negligible , severe bradycardia and urinary retention did not occur , and none of the patients in the two groups reported transient neurological symptoms over 24 h. In conclusion , plain mepivacaine in a 60- or 80-mg dose is a suitable local anesthetic choice for ambulatory spinal anesthesia with respect to anesthetic , as well as recovery profiles . IMPLICATIONS We evaluated the anesthetic and recovery profiles of 60- and 80-mg doses of plain mepivacaine for ambulatory spinal anesthesia . Both doses produced comparable sensory and motor block . Sensory and motor regression and ambulatory milestones were 20-30 min longer with the 80-mg dose . Side effects were negligible and transient neurological symptoms were not reported during a 24-h follow-up .
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Intervention_Pharmacological
plain mepivacaine
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Intervention_Pharmacological
subarachnoid lidocaine
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Intervention_Pharmacological
mepivacaine
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Intervention_Pharmacological
preservative-free plain mepivacaine
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Intervention_Pharmacological
plain mepivacaine
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Intervention_Physical
spinal-epidural anesthetic technique
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Intervention_Pharmacological
subarachnoid mepivacaine
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Intervention_Pharmacological
mepivacaine
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Outcome_Physical
cephalad dermatome level of the block
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Outcome_Physical
degree of motor block
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Outcome_Physical
Times to two-segment
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Outcome_Other
T-10 regression
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Outcome_Physical
Time to L-1 regression
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Outcome_Physical
hypotension
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Outcome_Adverse-effects
and
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Outcome_Physical
emesis
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Outcome_Physical
bradycardia
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Outcome_Physical
urinary retention
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Outcome_Physical
transient neurological symptoms
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Outcome_Physical
Sensory and motor regression
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Outcome_Adverse-effects
Side effects
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Outcome_Physical
transient neurological symptoms
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Participant_Condition
spinal anesthesia .
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Participant_Condition
Sixty patients
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Participant_Condition
spinal anesthesia