AN INTRADERMAL STUDY OF THE LOCAL ANAESTHETIC AND VASCULAR EFFECTS OF THE ISOMERS OF MEPIVACAINE

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Abstract
The duration of action and vascular effects of L(+) and D(-) and racemic mepivacaine were investigated in a double-blind study in 23 fit human volunteers. Isosmolar 0.1-ml intradermal injections of a range of concentrations of each agent from 0.011-2.7%, and physiological saline were given in duplicate to at least 14 subjects. Local color changes were observed 5-10 min after injection, and analgesia to pinprick was tested at 5 min intervals thereafter until full recovery. Both isomers were vasoconstrictor at concentrations of 0.3% and less; at greater concentration the L isomer produced more vasodilatation and hemorrhagic change. The duration of action of both isomers increased with concentration between 0.05-0.9%, but the L isomer was significantly longer acting than the D at 0.3% and more. The log dose-duration curve could be interpreted as linear between 0.1-0.9% with the slope of L isomer being twice as steep as the D. The findings for racemic mepivacaine were between those of the 2 isomers. The longer duration of analgesia of L-mepivacaine was not associated with superior vasoconstrictor power.

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