Polocaine (Mepivacaine Infiltration) - Summary

POLOCAINE SUMMARY

3% Polocaine^® Dental
(mepivacaine hydrochloride Injection, USP)
2% Polocaine^® Dental
with Levonordefrin 1:20,000
(mepivacaine hydrochloride and levonordefrin Injection, USP)

Mepivacaine hydrochloride is a local anesthetic available as sterile isotonic solutions (clear, colorless) in concentrations of 1%, 1.5% and 2% for injection via local infiltration, peripheral nerve block, and caudal and lumbar epidural blocks.

Mepivacaine hydrochloride is related chemically and pharmacologically to the amide-type local anesthetics.

POLOCAINE (Mepivacaine HCl Injection, USP), is indicated for production of local or regional analgesia and anesthesia by local infiltration, peripheral nerve block techniques, and central neural techniques including epidural and caudal blocks.

The routes of administration and indicated concentrations for mepivacaine are:

local infiltration	0.5% (via dilution) or 1%
peripheral nerve blocks	1% and 2%
epidural block	1%, 1.5%, 2%
caudal block	1%, 1.5%, 2%

See DOSAGE AND ADMINISTRATION for additional information. Standard textbooks should be consulted to determine the accepted procedures and techniques for the administration of mepivacaine.

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NEWS HIGHLIGHTS

Media Articles Related to Polocaine (Mepivacaine Infiltration)

Abdominal Surgery Without General Anesthesia
Source: GastroIntestinal / Gastroenterology News From Medical News Today [2009.11.04]
A recent review in Faculty of 1000 Medicine Reports, a publication in which clinicians highlight advances in medical practice, suggests regional pain relief could be used during abdominal surgery. In this review, Michael Schaefer recommends a new approach that can be performed without the need for general anaesthetics.

Anesthesia, Exertional Heat Deaths May Be Linked
Source: MedicineNet Hyperthermia Specialty [2009.10.26]
Title: Anesthesia, Exertional Heat Deaths May Be Linked
Category: Health News
Created: 10/23/2009 4:10:00 PM
Last Editorial Review: 10/26/2009

Anesthesia in Youngest Kids May be Linked to Learning Disabilities
Source: MedicineNet Hernia Specialty [2009.03.25]
Title: Anesthesia in Youngest Kids May be Linked to Learning Disabilities
Category: Health News
Created: 3/25/2009 2:00:00 AM
Last Editorial Review: 3/25/2009

Need For Emergency Airway Surgery For Hard-to-Intubate Patients Reduced
Source: Respiratory / Asthma News From Medical News Today [2009.11.18]
Be prepared, that old Boy Scout motto, is being applied with great success to operating room patients whose anatomy may make it difficult for physicians to help them breathe during surgery, Johns Hopkins researchers report in a new study. When patients undergo general anesthesia, they stop breathing on their own and anesthesiologists must quickly insert a tube into the airway as a first step in machine-assisted breathing.

New Technique For Injectable Facial Fillers Improves Comfort, Recovery
Source: Cosmetic Medicine / Plastic Surgery News From Medical News Today [2009.10.29]
Less pain during injections for wrinkle-fighting facial fillers. Less swelling afterward. Less time in the office waiting for anesthesia to take effect. These and other benefits of a new injection technique that UT Southwestern Medical Center plastic surgeons are helping pioneer are outlined in the October issue of Plastic and Reconstructive Surgery.

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Published Studies Related to Polocaine (Mepivacaine Infiltration)

Comparison between lidocaine-prilocaine cream (EMLA) and mepivacaine infiltration for pain relief during perineal repair after childbirth: a randomized trial. [2009.08]
OBJECTIVE: The purpose of this study was to compare the effectiveness of topically applied lidocaine-prilocaine (EMLA) cream with local anesthetic infiltration in the reduction of pain during perineal suturing after childbirth... CONCLUSION: EMLA cream appears to be an effective and satisfactory alternative to local anesthetic infiltration for the relief of pain during perineal repair.

Efficacy and safety of hyaluronidase 75 IU as an adjuvant to mepivacaine for retrobulbar anesthesia in cataract surgery. [2008.11]
PURPOSE: To evaluate the efficacy and safety of hyaluronidase as an adjuvant to mepivacaine for retrobulbar anesthesia in cataract surgery. SETTING: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, and Eye Center Munich East, Munich-Haar, Germany... CONCLUSION: The addition of hyaluronidase to mepivacaine for retrobulbar anesthesia in cataract surgery enhanced the safety of the surgical procedure due to more complete akinesia and quicker onset of complete anesthesia.

Hyaluronidase increases the duration of mepivacaine in inferior alveolar nerve blocks. [2008.02]
PURPOSE: To evaluate the duration of the effect of mepivacaine when hyaluronidase is injected immediately prior to the end of pulpal anesthesia... CONCLUSION: Hyaluronidase increases the duration of mepivacaine in inferior alveolar nerve blocks.

The effects of medetomidine on radial nerve blockade with mepivacaine in dogs. [2008.01]
OBJECTIVE: To compare the sensory and motor effects of adding medetomidine to mepivicaine, administered either perineurally or systemically, for radial nerve block in dogs. STUDY DESIGN: Prospective randomized cross-over study. ANIMALS: Six healthy Beagles, aged 18.7 +/- 6.3 months and weighing 10.4 +/- 1.3 kg... CONCLUSION: Medetomidine prolonged sensory and motor blockade after radial nerve block with mepivacaine in dogs. CLINICAL RELEVANCE: Medetomidine may prove to be a useful adjunct to peripheral nerve blockade with local anesthetics.

[Addition of sodium bicarbonate and/or clonidine to mepivacaine: influence on axillary brachial plexus block characteristics] [2006.11]
CONCLUSIONS: Adding NaHCO3 to mepivacaine shortens the time of onset of an axillary brachial plexus block. Including clonidine prolongs the duration of anesthesia and analgesia. The addition of both NaHCO3 and clonidine shortens time to onset but does not prolong duration of anesthesia or analgesia.

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Clinical Trials Related to Polocaine (Mepivacaine Infiltration)

Spinal Mepivicaine With Fentanyl for Outpatient Knee Arthroscopy [Recruiting]
The purpose of this study is to determine if the addition of intrathecal fentanyl to low dose mepivacaine spinal anesthesia provides adequate surgical anesthesia with shorter duration of motor blockade.

It is hypothesized that lower doses of spinal mepivacaine when combined with fentanyl will result in adequate surgical block for knee arthroscopy surgery with faster recovery and discharge compared to mepivacaine alone.

Ropivacaine vs Ropivacaine Plus Mepivacaine for Sciatic Block [Recruiting]
In loco regional anesthesia, much more than for general anesthesia, the choice of the product is largely left at the discretion of the practitioner. Two categories of local anesthetics are distinguished according to their pharmacodynamic characteristics: products with a short time of installation and a short duration period, and products with a longer delay of installation of the sensitive and motor block, but with a long-term duration. Indeed, the combined use of two products pharmacodynamically different seems to be of a practical interest.

This study provides a comparison of the onset of action of 30 ml of ropivacaine 0. 75% and 30ml of a mixture of ropivacaïne 0. 75% associated with mepivacaïne 1. 5% for the subgluteal sciatic nerve block. This is a prospective randomized double-blind study where the main criterion of judgment is the time of installation of a sensitive block compatible with surgery in the sciatic territory nerve. Fifteen patients per group were calculated to detect a 50% decrease of the onset of action in the combination group with a power of 90% and alpha to 5%, according to a previous pilot study. The secondary endpoints are the intensity and time of installation of the motor block, the duration of sensitive and motor block, the total dose of morphine administered within 48 hours, as well as its possible side effects.

Ultrasound Guided Supraclavicular Nerve Block [Recruiting]
This study will test the hypothesis that sequential injection of 1. 5% mepivacaine followed 90 seconds later by 0. 5% ropivacaine in ultrasound guided supraclavicular block provides a quicker onset and a longer duration of analgesia than an equi-dose mixture of the two local anesthetics.

Dexamethasone and Analgesic Duration After Supraclavicular Brachial Plexus Blockade [Recruiting]
Patients undergoing surgery of the hand often are treated with a nerve block in the shoulder/neck area that provides anesthesia/numbing during surgery. Nerve blocks usually last for a few hours after surgery and provide pain relief for this period. It may be possible to extend the duration of anesthesia by using a steroid, which has anti-inflammtory properties. This study will compare the duration of the nerve block when dexamethasone (steroid) is added to the anesthetic injected around the nerve.

Preanalgesic Effect of Gabapentin in Total Knee Repair [Recruiting]
The purpose of this study is to determine whether gabapentin, as a one time administration prior to a total knee replacement procedure, has opioid sparing effects and a reduction in pain scores.

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