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.

กลไกการออกฤทธิ์: 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.

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