Local Patterns of Use.

[Brenna's Dad]

Busy studying, and in an effort to procrastinate, thought I'd write a post.

Does anyone have any experience using Etidocaine, Mepivicaine, Ropivicaine, Prilocaine, or Levobupivicaine?

Except for the decreased cardiac affinity of the L-bupivicaine isomer, it seems like the above locals would offer little benefit over the biggies ie. Lidocaine, Bupivicaine, Tetracaine, Procaine and Chloroprocaine.

Is anyone using Prilocaine or has the Methemoglobinemia have everyone avoiding the drug? Anyone using Ropivicaine or Levobupivicaine in an effort to avoid the cardiotoxic effects of Marcaine?

Anyway, just curious about everyone's experience and the patterns of use are elsewhere in the country.

Anticipating your responses.

[Passin' Gas]

AANA Journal had an interesting article of "suspected methemoglobinemia following awake intubation: One possible effect of benzocaine topical anesthesia--A case report". AANA Journal, Volume 7, number 2, page 117.

[Brenna's Dad]

Apparently, all local anesthetics have the potential for methemoglobinemia, but Prilocaine has the baddest rap.