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PubMed1992

Adrenaline absorption: effect of pH in mepivacaine and bupivacaine solutions. A clinical study during halothane anesthesia.

The effect of the pH of the solution on the rate of absorption into the blood stream of locally-injected adrenaline using an adrenaline solution mixed with either mepivacaine or bupivacaine was investigated. Forty patients undergoing elective craniotomy received one of the following five solutions for subcutaneous and subgaleaic injection in the dose 0.5 ml/kg: 1) mepivacaine-adrenaline (pH = 6.1), 2) mepivacaine-adrenaline (pH = 7.5), 3) bupivacaine-adrenaline (pH = 6.1), 4) bupivacaine-adrenaline (pH = 7.4), or 5) adrenaline (pH = 6.1). Both mepivacaine and bupivacaine added to the adrenaline solution increased the plasma concentration of adrenaline. Alkalinization attenuated the peak concentration of adrenaline in the case of a mepivacaine-adrenaline solution, but not in the case of a bupivacaine-adrenaline solution.

Absorption↗
PubMed1992

Plasma prilocaine and mepivacaine concentrations after combined lumbosacral plexus block.

In a pharmacokinetic study of combined sciatic/3-in-1 block for lower limb surgery, the two moderate-acting local anaesthetics prilocaine and mepivacaine were compared. The mean maximum venous plasma concentrations of mepivacaine were more than twice as high as when prilocaine was used as anaesthetic (5.1 micrograms/ml vs. 2.37 micrograms/ml). When used in combination with the former, ornipressin did not reduce plasma concentrations of mepivacaine to values which were below the threshold for toxic symptoms (5-6 mg/ml). The peak plasma concentrations exceeded the threshold of 5 micrograms/ml in four of the nine patients of the mepivacaine group (maximum value 7.21 mg/ml) and in two of the nine patients of the mepivacaine+ornipressin group (maximum value 8.61 micrograms/ml).

Adult↗
PubMed2003

Mepivacaine alters vascular responsiveness to vasoconstrictors in aortic rings from normal and aortic-banded rats.

The present study investigated the effects of mepivacaine on the response of rat aorta to vasoconstrictors in normal and aortic-banded animals. Cardiac hypertrophy was induced in Wistar rats by aortic banding, while sham-operated animals served as controls. Isolated aortic rings with or without endothelium were contracted with potassium chloride and phenylephrine in the presence of mepivacaine (10(-3) M). Maximal tension was measured at the highest concentration of potassium chloride and phenylephrine. Maximal response to potassium chloride was reduced in the presence of mepivacaine both in normal and aortic-banded rings. As regards the vascular reactivity to phenylephrine, aortic rings with intact endothelium from aortic-banded rats have shown increased response as compared to normal. After mepivacaine administration this difference between normal and aortic-banded rats was abolished. In conclusion, in a model of cardiac hypertrophy such as that of aortic-banding, increased response to alpha1-adrenergic stimulation is observed, which is blunted by mepivacaine administration.

Anesthetics, Local↗
PubMed1976

Etidocaine in retrobulbar anaesthesia. A comparison with mepivacaine.

A new long-acting local anaesthetic, etidocaine (Duranest) has been compared to mepivacaine (Carbocaine) in retrobulbar anaesthesia in a double-blind trial including 45 patients. Solutions used were etidocaine 0.5% and 1% and mepivacaine 1%, all without adrenaline. The onset time was short and no difference was found between the solutions. The duration of analgesia and motor block was significantly longer with etidocaine 1% compared to mepivacaine 1%. In a following open study with etidocaine 1% and mepivacaine 1% about 80% of the the patients in the etidocaine group never experienced any post-operative pain compared to about 50% in the mepivacaine group. No signs of local or systemic toxicity were noted in the studies.

Acetanilides↗
PubMed1983

Inhibition of fast axonal transport in vitro by the local anesthetics prilocaine, mepivacaine, and bupivacaine.

The aim of the present study was to establish the concentrations of prilocaine, mepivacaine, and bupivacaine which are effective at blocking fast axonal transport, to determine whether prilocaine and mepivacaine offer a better prospect of dissociating conduction block and transport block in vivo than does lidocaine and whether bupivacaine offers a better prospect than etidocaine in the same context. Fast axonal transport of [3H]leucine-labeled proteins was studied in vitro in bullfrog spinal nerves and quantitated by liquid scintillation counting. Exposure of spinal nerves to 14 mM prilocaine reduced the quantity of 3H-labeled proteins which accumulated at a ligature by 86%, and exposure to 14 mM mepivacaine reduced it by 70%; 10 mM prilocaine reduced this same parameter by 54%, a degree of inhibition close to the 44% reduction caused by 14 mM lidocaine. The D(-) and L(+) stereoisomers of mepivacaine each reduced transport to the ligature by approximately 50% at a concentration of 14 mM. Bupivacaine reduced the accumulation of 3H-labeled proteins at the ligature by 49% at a 10 mM concentration (pH 6.2); its potency is close to that found for etidocaine in a previous study. Since prilocaine and mepivacaine are at least as potent as lidocaine as transport inhibitors and at blocking impulse conduction, these two anesthetics offer no advantage over lidocaine to achieve dissociation of conduction block from transport block in vivo. Bupivacaine appears to offer no advantage over etidocaine in the same context, as the two agents have a similar potency as local anesthetics and a similar potency as inhibitors of fast axonal transport.

Animals↗
PubMed2003

Intrathecal fentanyl, sufentanil, or placebo combined with hyperbaric mepivacaine 2% for parturients undergoing elective cesarean delivery.

UNLABELLED: Worldwide, long-acting bupivacaine is the most popular local anesthetic for spinal anesthesia in parturients undergoing elective cesarean delivery. With advances in surgical techniques, e.g., the Misgav Ladach method, and shorter duration of surgery, the local anesthetic mepivacaine, with an intermediate duration of action, may be a reasonable alternative. Our aim in the present study was to evaluate the effects of 2% hyperbaric mepivacaine alone, or combined with either intrathecal fentanyl (5 and 10 microg), or sufentanil (2.5 and 5 microg), on sensory, motor, and analgesic block characteristics, hemodynamic variables, and neonatal outcome in a randomized, prospective, and double-blinded study (n = 100, 20 parturients per group, singleton pregnancy, >37 wk of gestation). No parturient experienced intraoperative pain. The average duration of motor block Bromage 3 in all groups was 68 min, and resolution time to Bromage 0 was 118 min. Maximal cephalad sensory block level was T3-6 and could be established within 6 min. Complete analgesia was significantly prolonged in all groups receiving intrathecal opioids, yet, with sufentanil 5 microg, even the duration of effective analgesia was significantly extended. Neonatal outcome was not affected by intrathecal opioid administration. In conclusion, 2% hyperbaric mepivacaine is a feasible local anesthetic for spinal anesthesia in parturients undergoing elective cesarean delivery, particularly with short duration of surgery. IMPLICATIONS: Sensory, motor, and analgesic block characteristics of the local anesthetic mepivacaine alone or combined with intrathecal opioids were studied in parturients undergoing elective cesarean delivery in a randomized, double-blinded clinical trial. Mepivacaine was found to be an acceptable local anesthetic for spinal anesthesia in parturients undergoing cesarean delivery. In combination with sufentanil 5 microg, complete and effective analgesia were significantly prolonged.

Adult↗
PubMed1991

[Alkalinization of mepivacaine for axillary plexus anesthesia using a catheter].

One disadvantage of perivascular axillary block using a catheter technique is delayed temporal development of the blockade. Some clinical studies have concluded that pH-adjusted solutions of local anesthetics produce a more rapid onset of blockade. Alkalinization of mepivacaine for brachial block produced conflicting results. In the present study, we attempted to define the effect of alkalinization of mepivacaine 1% on clinical efficacy, onset, and regression in patients undergoing upper extremity surgery with axillary block using the catheter technique. METHODS. Sixty consecutive adult patients (ASA I-II) scheduled for upper extremity surgery under axillary block, were randomly assigned to one of two groups. In a double-blind fashion, 30 patients received 40 ml 1% mepivacaine, the pH of which had been raised to 7.25 by adding 4 ml 8.4% NaHCO3, and 30 received 40 ml commercially prepared 1% mepivacaine hydrochloride solution containing 4 ml 0.9% NaCl (pH 6.0). All patients received axillary block using the catheter technique. After placement of the block, a blinded observer tested sensory and motor blockade after 2 min, 5 min and then every 5 min for 30 min in each of the terminal nerves of the brachial plexus. Sensory blockade was determined by pinprick and graded in accordance with the scale proposed by Hollmèn: 0: Normal sensation of pinprick. 1: pinprick felt as sharp-pointed but weaker compared with the same area in the other upper extremity. 2: Pinprick recognized as touch with a blunt object. 3: No perception of touch. The gradation of motor blockade was 0: normal muscular function; 1: slight depression in muscular function compared with preanesthetic strength; 2: very weak action persisting in muscles; and 3: complete block. The results for each group were compared at every time interval. Duration of blockade was compared by evaluating the rate of regression within the first 2 h after placement of the block in each group. Mepivacaine plasma levels were measured by HPLC in 10 patients of each group prior to injection and 5, 10, 15, 20, 30, 60, and 120 min thereafter. Statistical comparison was made using the chi 2 and t tests. Differences were considered statistically significant when P-values were less than 0.05. RESULTS. The bicarbonate and saline groups were similar with respect to age, height, weight, and sex distribution. Significantly more patients in the bicarbonate group showed onset of motor blockade (grade 1) after 2 min with respect in the axillary, musculocutaneous, radial, and median nerves as well as onset of sensory blockade in the same nerves with a significant difference in blockade of the radial nerve. (ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1987

[Comparative study of 1% prilocaine and 1% mepivacaine in axillary plexus anesthesia].

In a randomized double-blind study, the latency period and spread of axillary brachial plexus block using 40 ml mepivacaine hydrochloride (1% solution), or prilocaine (1% solution) was studied in 60 patients scheduled for surgery of the hand and forearm regions. The sensory block of the axillary, musculocutaneus, radial, median, ulnar and medial brachial cutaneous nerves was recorded using the pin-prick test every 5 min after injection and the motor block was assessed by testing the power of the corresponding muscles up to 30 min after injection. The degree of intraoperative analgesia attained was also determined. The venous methemoglobin level was determined before and 2 h after the administration of the local anesthetic agent. The development of sensory blockade was significantly faster after 10 min and 15 min in the radial nerve, and the development of motor blockade after 15 min and 20 min in the axillary nerve, using mepivacaine. After 30 min, there were no significant differences in the degree of sensory or motor block attained between the two groups. Intraoperative analgesia was attained in 27 patients of the mepivacaine group, versus 23 patients of the prilocaine group (NS). The methemoglobin level was always elevated following prilocaine, but not following mepivacaine. Two patients had an increase of the methemoglobin concentration to more than 11% after the administration of prilocaine. Neither the higher toxicity to the central nervous and cardiovascular systems from mepivacaine, nor the methemoglobin formed by prilocaine seems to be of clinical significance with the dosage and technique employed.

Anesthesia, Local↗
PubMed1987

[Clinical and toxicologic study of axillary plexus block with prilocaine or mepivacaine].

A prospective controlled double-blind study was designed to compare the efficacy and the toxicity of mepivacaine and prilocaine for the axillary blockade of the brachial plexus. Twenty patients in each group received 40 ml of either 1.5% mepivacaine or 1.5% prilocaine. The sensory and the motor blockade achieved in both groups were comparable. The mean plasma levels attained following mepivacaine were significantly higher than those attained after prilocaine (peak-plasma level (mean +/- SD): 2.02 +/- 0.28 micrograms/ml vs 5.37 +/- 1.83 micrograms/ml). In four patients of the mepivacaine group, the plasma levels entered the toxic range. While no methemoglobinemia could be detected following mepivacaine, four of the patients receiving prilocaine developed methemoglobinemia with a maximum level of 10%. No complications due to methemoglobinemia were observed in any of the patients. Because of its significantly lower toxic potential, prilocaine seems to be the better local anaesthetic for axillary blockade of the brachial plexus.

Adult↗
PubMed1985

Spinal fluid concentrations of mepivacaine in horses and procaine in cows after thoracolumbar subarachnoid analgesia.

The CSF concentrations of mepivacaine in 10 Standardbred horses and of procaine in 10 Holstein cows given the drugs by thoracolumbar subarachnoid injection were determined. Mepivacaine hydrochloride was injected into the horses (502 +/- 60.5 kg) at an average dosage of 30 mg (1.5 ml of 20 mg/ml solution). Analgesia was produced 7.5 +/- 4.3 minutes after injection, extended between spinal cord segments T13 and L3 on both sides of the spinal column, and lasted 47 +/- 18.7 minutes at the T18 dermatome. Procaine hydrochloride was injected into cows (614 +/- 51.5 kg) at a dosage ranging between 75 mg and 100 mg (1.5 ml and 2 ml of 50 mg/ml solution). Analgesia was produced 8.2 +/- 2.0 minutes after injection, extended between spinal cord segments T11 and L4 on both sides of the spinal column, and lasted 47 +/- 17.5 minutes at the T13 dermatome. The critical CSF concentrations of local anesthetics required to eliminate response to pinprick stimulation were 204.4 +/- 90.3 micrograms of mepivacaine/ml in horses and 197.0 +/- 86.1 micrograms of procaine/ml in cows. Average CSF concentrations at 120 minutes after injections were made were 16.8 +/- 15.5 micrograms of mepivacaine/ml and 30.6 +/- 17.1 micrograms of procaine/ml. In in vitro experiments to determine the rates of hydrolysis of mepivacaine and procaine in CSF, significant changes (P greater than 0.05) were not seen in the CSF concentrations of mepivacaine in horses and procaine in cattle after a 120-minute incubation (37 C). The analgesic threshold concentrations of mepivacaine in CSF of horses and procaine in CSF of cows were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Spinal↗
PubMed1996

[The level of analgesia with epidural injection of 2% mepivacaine using combined spinal and epidural analgesia].

We studied the level of analgesia obtained with epidural injection of 2% mepivacaine using combined spinal and epidural analgesia (CSE) and compared with the level obtained by epidural analgesia (EA). We inserted a catheter into the epidural space through the L2/3 interspace, and hyperbaric tetracaine was injected through the L3/4 interspace with 26G spinal needle in thirty patients for CSE. We checked the the level of analgesia 90 min after spinal anesthesia. After this, 23 out of 30 patients showed the extension of analgesia 15 min after injection of mepivacaine into the epidural catheter. In these patients, the level of analgesia and the dose of mepivacaine showed the regression line Y = 10.2-0.4X (Y: the level of analgesia, X: the dose of 2% mepivacaine, P < 0.05). We also showed the regression line Y = 16.1-0.7X (P < 0.05) for EA 15 min after epidural injection of mepivacaine in other 23 patients. To achieve the same level of analgesia of Th8 or Th6 with CSE and EA, the doses for epidural injection were calculated as 5.5 ml, 10.5 ml with CSE and 11.5 ml, 14.4 ml with EA, respectively. These results show that the epidural dose of local anesthetic for CSE is 1/2 to 2/3 of that necessary for EA.

Adult↗
PubMed1997

[The effects of carbonation on 2% mepivacaine in epidural anesthesia].

OBJECTIVES: To evaluate the clinical effects of 2% carbonated mepivacaine in arthroscopic surgery of the knee. PATIENTS AND METHOD: Thirty patients were enrolled in this prospective, double-blind study, and randomly assigned to two groups to receive 2% mepivacaine plus saline (group I, n = 15) or 2% mepivacaine plus bicarbonate soda. The alkalinized solution was prepared by adding 0.1 mEq of 8.4% bicarbonate soda to each ml of 2% mepivacaine. A total volume of 16 ml of the mixture assigned was injected through an epidural catheter. Variables recorded were time until sensory blockade, maximum cephalad spread, number of marked dermatomes, regression time, degree of motor blockade and time until start of surgery. RESULTS: Fewer marked dermatomes were observed in group II than in group I after 5 minutes (6.5 +/- 3.3 versus 9.3 +/- 2.8), after 15 minutes (1.5 +/- 1 versus 3 +/- 2.2), at 20 minutes (1 +/- 1.1 versus 1.8 +/- 0.9) and after 25 minutes (0.4 +/- 0.7 versus 1.2 +/- 1.2) (p < 0.05). We observed no significant differences in time until start of analgesia, maximum cephalad spread of sensory blockade or degree of sensory blockade. CONCLUSIONS: Alkalinization of 2% mepivacaine delivered epidurally improves the quality of blockade, decreasing time until start of surgery. However, the slight clinical significance of these results does not appear to justify general application.

Adult↗
PubMedDate not supplied

Mepivacaine as an intravenous regional block interferes with reactive hyperemia and decreases steady-state blood flow.

BACKGROUND AND OBJECTIVES: Local anesthetics block propagation in nerve fibers but may also inhibit inflammation. Inflammatory phenomena such as warmth, reddening, and swelling are intimately connected with blood flow. Our primary aim was to investigate the effect of mepivacaine on cutaneous blood flow in a situation involving hyperemia, but no inflammation, namely, after arterial occlusion. METHODS: The subjects were healthy volunteers (9 men, 7 women). Pain was evaluated by visual analog scale every 5 minutes. A laser Doppler probe was applied on each forearm. After baseline flow measurements during 30 minutes, a bilateral regional intravenous block (Bier block) was performed by injecting mepivacaine (1.4 mg/kg in 40 mL) in one arm and normal saline in the other in a randomized, controlled, double-blind manner. Arterial occlusion was maintained for 20 minutes, and flow was followed for 60 minutes after release of the block. RESULTS: The ischemic pain, though modest, was less (P = .045) in the treated arm. Following release of the cuff, the blood flow had essentially stabilized after 20 minutes. The reactive hyperemia (1-20 minutes) was attenuated in the mepivacaine-treated arm (mean, 68% of placebo, P = .025). In the 21-60-minute period, flow in this arm stabilized at a lower level (mean, 73% of placebo, P = .0013). CONCLUSION: Mepivacaine is a vasoconstrictor of long duration. This has to be taken into account when antiinflammatory effects of mepivacaine are assessed.

Adult↗
PubMed1997

[The utility of digital infiltration of mepivacaine and ketorolac in postoperative analgesia of the unilateral hallux valgus].

OBJECTIVES: To determine whether locally injected ketorolac provides analgesia additional to that of mepivacaine, and also to prevent, diminish or delay the peripheral hypersensitivity response of postoperative pain. PATIENTS AND METHODS: Prospective, randomized, double-blind study of 72 patients scheduled for surgery to correct unilateral hallux valgus. Group 1 (n = 24) received median infiltration at the first metatarsus of 5 ml of 2% mepivacaine and 1 ml (30 mg) of ketorolac. Group 2 (n = 21) received local infiltration of 5 ml of 2% mepivacaine and 1 ml of saline solution. Group 3, the control group (n = 27) received the same solution as did group 2, plus 30 mg of ketorolac intravenously. The postoperative analgesia prescribed was 10 mg of ketorolac orally every 8 hours. Pain was measured on a visual analog scale (VAS) 0, 1, 4, 8 and 24 hours after surgery. Time elapsed until the appearance of pain, number of ketorolac pills consumed and overall patient satisfaction were recorded. RESULTS: There were no differences in anthropometric characteristics. Time until pain appeared was significantly longer in group 1 than in groups 2 and 3 (14.66 +/- 7.19, 5.90 +/- 2.27 and 8.70 +/- 5.02 hours, respectively). The VAS scores were significantly lower in group 1 after the fourth postoperative hour. Analgesic consumption was significantly lower in group 1. CONCLUSIONS: Infiltration of 30 mg of ketorolac along with mepivacaine delays the appearance of postoperative pain and diminishes it in the first 24 hours after surgery to correct hallux valgus, in comparison with infiltration of mepivacaine alone plus intravenous ketorolac.

Adult↗
PubMed1980

Brain-to-blood and saliva-to-blood mepivacaine ratios in rats.

Mepivacaine hydrochloride, 25 and 50 mg/kg sc (with sacrifice at 15 min) produced higher (p less than 0.005) drug levels in neonate (24--36-hr-old) rat brain and blood than in adult rat brain and blood; however, there was no significant difference in the brain-to-blood ratio of the drug between neonates and adults at either dose level. Intraarterial infusion of mepivacaine hydrochloride (20 micrograms/min) in adult rats resulted in measurable (GLC) mepivacaine base levels in pilocarpine-induced parotid salivary secretions collected throughout 30- and 45-min infusion periods. The saliva-to-blood ratios (+/- SEM) of mepivacaine base were 0.64 +/- 0.13 after a 30-min infusion and 2.13 +/- 0.48 after a 45-min infusion.

Aging↗
PubMed1988

Effects of caudal block with mepivacaine on resting ventilation and ventilatory response to carbon dioxide in sedated children.

We examined the effects of caudal anaesthesia using 10 mg.kg-1 of one or two per cent mepivacaine without epinephrine on resting ventilation, arterial blood gas tensions and the ventilatory response to carbon dioxide in 27 sedated children. Expired minute volume and respiratory frequency decreased significantly after the caudal blocks in both groups. PaO2 and PaCO2 remained unchanged in both groups. The slope of the CO2 response curve increased significantly in both groups. The mean plasma mepivacaine levels were 4.6 +/- 1.6 (SD) and 4.6 +/- 1.0 micrograms.ml-1 20 minutes after the caudal blocks with one and two per cent mepivacaine, respectively. These results demonstrate that resting ventilation is impaired but the ventilatory response to carbon dioxide is improved similarly by caudal block with one or two per cent mepivacaine.

Anesthesia, Caudal↗
PubMed1998

[Does intrathecal clonidine prolong the effect of spinal anesthesia with hyperbaric mepivacaine? A randomized double-blind study].

BACKGROUND: Clonidine, an alpha 2-receptor agonist, has been reported to prolong the blocking actions of local anaesthetics. The aim of this study was to investigate the effects of spinally injected clonidine on the duration of spinal anaesthesia by mepivacaine and on the postoperative demand for analgesics. METHODS: Forty-five patients who had transurethral urological surgery under spinal anaesthesia were randomized to 3 groups (n = 15 each) and studied in a double-blind fashion. Group I received 80 mg mepivacaine 4% only, while in group II mepivacaine was combined with 75 micrograms clonidine intraspinally and in group III with 150 micrograms clonidine. Onset time, spread of anaesthesia, duration of sensory and motor blockade, regression of anaesthesia and postoperative demand for analgesics were recorded. In addition heart rate and mean arterial pressure were measured at regular intervals. RESULTS: Clonidine had no effect on the onset time and spread or intensity of spinal anaesthesia. The higher dose of clonidine significantly prolonged the duration of sensory blockade by 50 min and the duration of motor block by 40 min, while 75 micrograms had no significant effect. Heart rate and mean arterial pressure were significantly reduced in both clonidine groups when compared to plain mepivacaine. There was no significant reduction in postoperative analgesic demand. CONCLUSION: While clonidine prolonged sensory analgesia, there was also an undesirable prolongation of motor block postoperatively. In addition, there was a significant and long lasting reduction in heart rate and mean arterial pressure in both clonidine groups. Unfavourably, postoperative demand of analgesics was not reduced by spinal injection of clonidine. Thus, the routine addition of clonidine for spinal anaesthesia with local anaesthetics is not recommended.

Adrenergic alpha-Agonists↗
PubMed2004

Ropivacaine produces sensory blockade in the lumbar sacral region more frequently than mepivacaine in lower thoracic epidural anesthesia.

PURPOSE: The first sacral nerve has the largest diameter among the spinal nerves and is resistant to local anesthetics. Ropivacaine is a newly developed local anesthetic. There is a possibility that a difference in chemical properties between ropivacaine and other local anesthetics produces a difference in the blockade of the S1 dermatome by lower thoracic epidural anesthesia. Mepivacaine, 2%, is frequently used for epidural anesthesia and produces a level of blockade similar to that of bupivacaine, 0.5%. The purpose of this study was to examine the sensory blockade in the sacral region induced by ropivacaine with that induced by mepivacaine administered in the lower thoracic epidural space. METHODS: Eighteen adults undergoing lower thoracic epidural anesthesia (thoracic 11/12 interspace) were studied in a double-blind fashion. Patients were assigned to one of two groups: those who received 2% mepivacaine, 18 ml (group M; n = 9), and those who received 1% ropivacaine, 12 ml (group R; n = 9). The cephalad levels of sensory blockade to cold, pinprick, and touch in the L2, S1, and S3 dermatomes were assessed at 10, 20, and 35 min after injection. RESULTS: There were no differences in the cephalad levels of sensory block to cold (T4 [range, T4-T2] and T4 [range, T6-T2]), pinprick (T4 [range, T6-T4] and T4 [range, T6-T4]), or touch (T6 [range, T6-T4] and T6 [range, T6-T4]) between group M and group R respectively, at 35 min (P > 0.05). In the L2 and S3 dermatomes, there were no significant differences in the numbers of patients who obtained sensory block to cold or pinprick at 20 and 35 min after study drug administration. However, in the S1 dermatome, significantly higher numbers of patients in group R obtained sensory block to cold at 20 and 35 min after study drug administration than in group M (8 and 0; 9 and 0; P = 0.001 and P < 0.001; 20 min and 35 min after administration, respectively). Also in the S1 dermatome, significantly higher numbers of patients in group R obtained sensory block to pinprick at 20 and 35 min after study drug administration than in group M (6 and 0; 9 and 0; P = 0.027 and P < 0.001; 20 min and 35 min after administration, respectively). A significantly higher number of patients in group R had sensory block to touch in the S3 dermatome at 35 min (7 and 2; group R and group M, respectively; P = 0.01). CONCLUSION: Ropivacaine, 1%, administered in the lower thoracic epidural space, induces sensory blockade to cold and pinprick in the S1 dermatome more frequently than 2% mepivacaine.

Adult↗