SynthesisAdvances in therapy2022
Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials.
Synthesis in Advances in therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 6 citations in OpenAlex.
- Rat Model: Intrathecal Lipid for Total Spinal Block-Induced Hemodynamic Instability.Journal of clinical practice and research · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionBupivacaine is a more widely used anesthetic than mepivacaine. However, the long-acting effects of bupivacaine often lead to slow and unpredictable return. As an intermediate-acting local anesthetic, mepivacaine can enable earlier ambulation and thus has other benefits. We performed a systematic review and meta-analysis of available randomized controlled trials (RCTs) comparing the anesthetic effects of mepivacaine and bupivacaine.
methodsOn August 12, 2021, a search was performed in PubMed, Embase, and the Cochrane Library. Effect estimates with 95% CI were combined using a random effects model. We performed sensitivity analyses to explore sources of heterogeneity and stability of results.
resultsOf the 406 papers screened, 14 population-based randomized controlled trials were included, with a total of 1007 patients. Overall, compared to bupivacaine, mepivacaine was associated with higher numbers of motor block 3 (OR, 4.05; 95% CI 1.92-8.57), shorter length of stay (SMD, - 0.77; 95% CI - 1.52 to - 0.03), faster recovery from motor block (SMD, - 1.45; 95% CI - 2.39 to - 0.51), and shorter time to return to voiding (SMD, - 1.24; 95% CI - 1.83 to - 0.64). Mepivacaine was associated with a higher incidence of transient neurologic symptoms (TNS) and transient nerve root irritation (TRI) (OR, 9.18; 95% CI 2.42-34.88). There was no statistical difference between the two anesthetics in terms of pain index on the postoperative day (SMD, 0.20; 95% CI - 0.06 to 0.46) and incidence of urinary retention (OR, 0.98; 95% CI 0.47-2.03).
conclusionsMepivacaine may have advantages over bupivacaine in terms of achieving motor block 3, shorter length of stay, earlier recovery from motor block, and earlier time to return to voiding, but it may have a higher incidence of TNS or TRI than bupivacaine. Therefore, mepivacaine may be used before bupivacaine in spinal anesthesia.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.