Mepivacaine
Mepivacaine is an amide-type local anesthetic used for perineural blockade, local infiltration, and intra-articular analgesia. **Key Clinical Features:** * It has **less intrinsic vasodilator activity** than lidocaine and is considered less irritant to tissues. * It possesses equivalent potency to lidocaine but has a slightly longer duration of action (**100-120 minutes**). * Unlike some other local anesthetics, it **does not require the addition of adrenaline** (epinephrine) to prolong its effect. > **Clinical Warning:** Mepivacaine must never be injected intravenously. Inadvertent IV injection can lead to severe systemic toxicity, including convulsions and cardiac arrest.
Mechanism: Local anesthetic action is dependent on the reversible blockade of the **voltage-gated sodium channels** → prevents the influx of sodium ions → prevents the propagation of an action potential along the nerve fiber. Sensory nerve fibers are blocked before motor nerve fibers, allowing a selective sensory blockade at low doses.
Dosing by species
- Local or perineural blockade · Inject the minimal volume required to achieve an effect · Local/Perineural · Single dose · 100-120 min · Toxic doses have not been established in companion animals.
- Intra-articular analgesia (e.g., prior to arthroscopy) · 2 mg/kg of the 2% solution · Intra-articular · Single dose · 100-120 min · Injected into the elbow joint prior to arthroscopy; found to decrease the haemodynamic response to surgery.
- Local or perineural blockade · Inject the minimal volume required to achieve an effect · Local/Perineural · Single dose · 100-120 min · Toxic doses have not been established in companion animals.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Routes of administration
Contraindications
- Intravenous (IV) injection
Adverse effects
- Convulsions (associated with inadvertent IV injection or overdose)
- Cardiac arrest (associated with inadvertent IV injection or overdose)
Monitoring
- Heart rate and rhythm (ECG)
- Blood pressure
- Neurological status (monitor for signs of toxicity such as muscle twitching or seizures)
Overdose
Toxic doses of mepivacaine have not been established in companion animals. Inadvertent intravenous injection or massive overdose may cause severe systemic toxicity, manifesting as **convulsions** and/or **cardiac arrest**. Treatment is supportive and symptomatic (e.g., seizure control, cardiovascular support, potentially intravenous lipid emulsion therapy).
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.