PT  - JOURNAL ARTICLE
AU  - Carley, Michelle
AU  - Sheetz, Miriam
AU  - Lauzadis, Justas
AU  - Zhong, Haoyan
AU  - DelPizzo, Kathryn
TI  - EP248 Mepivacaine dosing for spinal anesthesia in pediatric orthopedic surgery: a retrospective chart review
AID  - 10.1136/rapm-2023-ESRA.308
DP  - 2023 Sep 01
TA  - Regional Anesthesia & Pain Medicine
PG  - A173--A173
VI  - 48
IP  - Suppl 1
4099  - http://rapm.bmj.com/content/48/Suppl_1/A173.1.short
4100  - http://rapm.bmj.com/content/48/Suppl_1/A173.1.full
SO  - Reg Anesth Pain Med2023 Sep 01; 48
AB  - Background and Aims There is substantial literature on the use of spinal anesthesia in pediatric patients with bupivacaine, particularly in infants. Bupivacaine is a long- acting local anesthetic which is well suited to surgery in infants but less ideal for ambulatory surgery procedures in older children. Mepivacaine is an intermediate-acting agent commonly used for spinal anesthesia in adults and has potential benefits for use in older children. Currently, there are no published pediatric dosing guidelines for spinal mepivacaine. At Hospital for Special Surgery, mepivacaine is routinely used for spinal anesthesia in children. The aim of this study is to generate mepivacaine dosing guidelines based on milligrams per kilogram (mg/kg) and age.Methods We performed a retrospective chart review of children who received mepivacaine for spinal anesthesia between 2016 to 2022.Results The data extraction yielded 5,448 cases. Patient age ranged from 5 to 21 years. Mean surgery duration was 119 minutes (SD=48). Mean PACU length of stay was 222 minutes (SD=95). Weight in kilograms (kg) and mepivacaine dosage in milligrams (mg) was recorded for all patients (figure 1). The range and SD of total milligrams administered by age was also recorded (table 1). Median dosage in mg/kg of mepivacaine was calculated for each age group. Our analysis reveals that required dosage in mg/kg decreases by patient age and begins to plateau at age 15 (figure 2).View this table:Abstract EP248 Table 1 | Range of total milligrams of mepivacaine administered by ageAbstract EP248 Figure 1 | Mean total mepivacaine dose administered by ageAbstract EP248 Figure 2 | Mepivacaine dosage in mg/kg reported as a function of patient ageConclusions We describe mepivacaine dosage as a function of age and weight in children. As age and weight increase, a lower dose of mepivacaine per kg is required for spinal anesthesia.IRB 2022-0706 approval