Mepivacaine dosing for spinal anesthesia in pediatric orthopedic surgery: a retrospective chart review.

Autor:	Carley M; Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York, USA carleymi@hss.edu.; Anesthesiology, Weill Cornell Medical College, New York, New York, USA., Sheetz M; Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York, USA., Lauzadis J; Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York, USA., Zhong H; Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York, USA., DelPizzo K; Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York, USA.; Anesthesiology, Weill Cornell Medical College, New York, New York, USA.
Jazyk:	angličtina
Zdroj:	Regional anesthesia and pain medicine [Reg Anesth Pain Med] 2024 Feb 02. Date of Electronic Publication: 2024 Feb 02.
DOI:	10.1136/rapm-2023-105093
Abstrakt:	Background: Mepivacaine is an intermediate-acting local anesthetic used for spinal anesthesia in adults. Currently, there are no published dosing guidelines for spinal mepivacaine in patients under age 18. Aims: The purpose of this study is to describe the clinically used doses of mepivacaine by weight and age for orthopedic surgery in pediatrics. Methods: We performed a retrospective chart review of patients aged 0-18 who received mepivacaine for spinal anesthesia from 2016 to 2022. We performed a secondary analysis for patients aged 0-18 who received spinal anesthesia with bupivacaine or chloroprocaine. Results: The data extraction yielded 3627 single-shot mepivacaine spinals. Patient age ranged from 5 to 18 years. Median dosage in milligrams/kilograms (mg/kg) of mepivacaine was calculated for each age group. Our analysis revealed that dosage in mg/kg decreased by patient age and began to plateau at age 15. Bupivacaine was the most common single-shot spinal agent in patients under age 10. After age 10, mepivacaine was more common. Chloroprocaine began to be used in patients older than 8 years. Conclusions: We describe mepivacaine dosage as a function of age and weight in patients younger than 18 years. As age and weight increased, a lower dose of mepivacaine per kg was administered for spinal anesthesia. (© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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