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Mepivacaine – a comeback medicine for pain control in Knee Replacement Surgery

Mepivacaine – a comeback medicine for pain control in Knee Replacement Surgery

Dr.Jason Davis said that the study suggests mepivacaine has multiple advantages and few drawbacks compared to bupivacaine as a spinal anaesthetic in knee replacement surgery.

According to Dr Jason “It shows promise as an ideal anaesthetic by working long enough for most knee replacements without the excessive duration that can delay patients’ recovery.”

Bupivacaine was successfully established in the 1990s, use of mepivacaine became limited after research showed it had a higher incidence of post-surgery complications like nerve irritation.

Bupivacaine binds to the intracellular portion of voltage-gated sodium channels and blocks sodium influx into nerve cells, which prevents depolarization. Without depolarization, no initiation or conduction of a pain signal can occur.

The possible side effects of the drug mepivacaine include rash, wheezing, trouble breathing or swallowing, acidosis, signs of methemoglobinemia etc.

But many recent studies do not agree with those previous concerns and emphasised that Mepivacaine has shown improved side effects with improved recovery of normal nerve function.

Dr Davis says. “Choosing the right anaesthetic may now be the key to attain a faster recovery with a lower risk of complications after surgery. Such shorter acting medications have the potential to become the new standard for regional anaesthesia during the migration to outpatient joint replacement.”

The study concluded that mepivacaine was found to be as effective for controlling pain with fewer side effects as bupivacaine. Patients who received mepivacaine recovered normal function faster, which allowed for a quicker recovery and shorter hospital stay and did not display worse pain control or transient neurologic symptoms afterwards.

 The study was published in The Journal of Arthroplasty.

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Source: With inputs from Journal of Arthroplasty

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