Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials

Introduction Bupivacaine 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 s...
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Autor*in:	Tan, Haifeng [verfasserIn] Wan, Teng Guo, Weiming Fan, Gang Xie, Yu

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	Mepivacaine Bupivacaine Anesthesia Meta

Anmerkung:	© The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2022

Übergeordnetes Werk:	Enthalten in: Advances in therapy - Tarporley : Springer Healthcare Communications, 2000, 39(2022), 5 vom: 16. März, Seite 2151-2164
Übergeordnetes Werk:	volume:39 ; year:2022 ; number:5 ; day:16 ; month:03 ; pages:2151-2164

Links:	Volltext

DOI / URN:	10.1007/s12325-022-02088-3

Katalog-ID:	SPR046886257

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520			\|a Introduction Bupivacaine 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. Methods On 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. Results Of 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). Conclusions Mepivacaine 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.
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allfields	10.1007/s12325-022-02088-3 doi (DE-627)SPR046886257 (SPR)s12325-022-02088-3-e DE-627 ger DE-627 rakwb eng Tan, Haifeng verfasserin aut Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2022 Introduction Bupivacaine 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. Methods On 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. Results Of 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). Conclusions Mepivacaine 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. Mepivacaine (dpeaa)DE-He213 Bupivacaine (dpeaa)DE-He213 Anesthesia (dpeaa)DE-He213 Meta (dpeaa)DE-He213 Wan, Teng aut Guo, Weiming aut Fan, Gang aut Xie, Yu aut Enthalten in Advances in therapy Tarporley : Springer Healthcare Communications, 2000 39(2022), 5 vom: 16. März, Seite 2151-2164 (DE-627)563170433 (DE-600)2421646-X 1865-8652 nnns volume:39 year:2022 number:5 day:16 month:03 pages:2151-2164 https://dx.doi.org/10.1007/s12325-022-02088-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2022 5 16 03 2151-2164
spelling	10.1007/s12325-022-02088-3 doi (DE-627)SPR046886257 (SPR)s12325-022-02088-3-e DE-627 ger DE-627 rakwb eng Tan, Haifeng verfasserin aut Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2022 Introduction Bupivacaine 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. Methods On 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. Results Of 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). Conclusions Mepivacaine 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. Mepivacaine (dpeaa)DE-He213 Bupivacaine (dpeaa)DE-He213 Anesthesia (dpeaa)DE-He213 Meta (dpeaa)DE-He213 Wan, Teng aut Guo, Weiming aut Fan, Gang aut Xie, Yu aut Enthalten in Advances in therapy Tarporley : Springer Healthcare Communications, 2000 39(2022), 5 vom: 16. März, Seite 2151-2164 (DE-627)563170433 (DE-600)2421646-X 1865-8652 nnns volume:39 year:2022 number:5 day:16 month:03 pages:2151-2164 https://dx.doi.org/10.1007/s12325-022-02088-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2022 5 16 03 2151-2164
allfields_unstemmed	10.1007/s12325-022-02088-3 doi (DE-627)SPR046886257 (SPR)s12325-022-02088-3-e DE-627 ger DE-627 rakwb eng Tan, Haifeng verfasserin aut Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2022 Introduction Bupivacaine 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. Methods On 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. Results Of 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). Conclusions Mepivacaine 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. Mepivacaine (dpeaa)DE-He213 Bupivacaine (dpeaa)DE-He213 Anesthesia (dpeaa)DE-He213 Meta (dpeaa)DE-He213 Wan, Teng aut Guo, Weiming aut Fan, Gang aut Xie, Yu aut Enthalten in Advances in therapy Tarporley : Springer Healthcare Communications, 2000 39(2022), 5 vom: 16. März, Seite 2151-2164 (DE-627)563170433 (DE-600)2421646-X 1865-8652 nnns volume:39 year:2022 number:5 day:16 month:03 pages:2151-2164 https://dx.doi.org/10.1007/s12325-022-02088-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2022 5 16 03 2151-2164
allfieldsGer	10.1007/s12325-022-02088-3 doi (DE-627)SPR046886257 (SPR)s12325-022-02088-3-e DE-627 ger DE-627 rakwb eng Tan, Haifeng verfasserin aut Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2022 Introduction Bupivacaine 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. Methods On 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. Results Of 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). Conclusions Mepivacaine 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. Mepivacaine (dpeaa)DE-He213 Bupivacaine (dpeaa)DE-He213 Anesthesia (dpeaa)DE-He213 Meta (dpeaa)DE-He213 Wan, Teng aut Guo, Weiming aut Fan, Gang aut Xie, Yu aut Enthalten in Advances in therapy Tarporley : Springer Healthcare Communications, 2000 39(2022), 5 vom: 16. März, Seite 2151-2164 (DE-627)563170433 (DE-600)2421646-X 1865-8652 nnns volume:39 year:2022 number:5 day:16 month:03 pages:2151-2164 https://dx.doi.org/10.1007/s12325-022-02088-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2022 5 16 03 2151-2164
allfieldsSound	10.1007/s12325-022-02088-3 doi (DE-627)SPR046886257 (SPR)s12325-022-02088-3-e DE-627 ger DE-627 rakwb eng Tan, Haifeng verfasserin aut Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2022 Introduction Bupivacaine 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. Methods On 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. Results Of 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). Conclusions Mepivacaine 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. Mepivacaine (dpeaa)DE-He213 Bupivacaine (dpeaa)DE-He213 Anesthesia (dpeaa)DE-He213 Meta (dpeaa)DE-He213 Wan, Teng aut Guo, Weiming aut Fan, Gang aut Xie, Yu aut Enthalten in Advances in therapy Tarporley : Springer Healthcare Communications, 2000 39(2022), 5 vom: 16. März, Seite 2151-2164 (DE-627)563170433 (DE-600)2421646-X 1865-8652 nnns volume:39 year:2022 number:5 day:16 month:03 pages:2151-2164 https://dx.doi.org/10.1007/s12325-022-02088-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2022 5 16 03 2151-2164
language	English
source	Enthalten in Advances in therapy 39(2022), 5 vom: 16. März, Seite 2151-2164 volume:39 year:2022 number:5 day:16 month:03 pages:2151-2164
sourceStr	Enthalten in Advances in therapy 39(2022), 5 vom: 16. März, Seite 2151-2164 volume:39 year:2022 number:5 day:16 month:03 pages:2151-2164
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Mepivacaine Bupivacaine Anesthesia Meta
isfreeaccess_bool	false
container_title	Advances in therapy
authorswithroles_txt_mv	Tan, Haifeng @@aut@@ Wan, Teng @@aut@@ Guo, Weiming @@aut@@ Fan, Gang @@aut@@ Xie, Yu @@aut@@
publishDateDaySort_date	2022-03-16T00:00:00Z
hierarchy_top_id	563170433
id	SPR046886257
language_de	englisch
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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. Methods On 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. Results Of 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). Conclusions Mepivacaine 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. 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author	Tan, Haifeng
spellingShingle	Tan, Haifeng misc Mepivacaine misc Bupivacaine misc Anesthesia misc Meta Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials
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topic_title	Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials Mepivacaine (dpeaa)DE-He213 Bupivacaine (dpeaa)DE-He213 Anesthesia (dpeaa)DE-He213 Meta (dpeaa)DE-He213
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title	Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials
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title_full	Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials
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author_browse	Tan, Haifeng Wan, Teng Guo, Weiming Fan, Gang Xie, Yu
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doi_str_mv	10.1007/s12325-022-02088-3
title_sort	mepivacaine versus bupivacaine for spinal anesthesia: a systematic review and meta-analysis of random controlled trials
title_auth	Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials
abstract	Introduction Bupivacaine 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. Methods On 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. Results Of 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). Conclusions Mepivacaine 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. © The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2022
abstractGer	Introduction Bupivacaine 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. Methods On 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. Results Of 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). Conclusions Mepivacaine 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. © The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2022
abstract_unstemmed	Introduction Bupivacaine 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. Methods On 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. Results Of 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). Conclusions Mepivacaine 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. © The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2022
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container_issue	5
title_short	Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials
url	https://dx.doi.org/10.1007/s12325-022-02088-3
remote_bool	true
author2	Wan, Teng Guo, Weiming Fan, Gang Xie, Yu
author2Str	Wan, Teng Guo, Weiming Fan, Gang Xie, Yu
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doi_str	10.1007/s12325-022-02088-3
up_date	2024-07-04T00:52:47.223Z
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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. Methods On 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. Results Of the 406 papers screened, 14 population-based randomized controlled trials were included, with a total of 1007 patients. 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Mepivacaine Versus Bupivacaine for Spinal Anesthesia: A Systematic Review and Meta-analysis of Random Controlled Trials

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