The first step of management consists of immediate attention to the maintenance of a patent airway and assisted or controlled ventilation with oxygen and a delivery system capable of permitting immediate positive airway pressure by mask. The clinician should be familiar prior to the use of local anaesthetics, with these anti-convulsant drugs. Supportive measures of circulatory depression may require administration of intravenous fluids, and when appropriate a vasopressor as directed by the clinical situation. If not treated immediately, both convulsion and cardio-vascular depression can result in hypoxia, acidosis, bradycardia, arrhythmias and ca diac arrest. If cardiac arrest should occur, standard cario-pulmonary resuscitative measures should be instituted.
Dialysis is of negligable value in the treatment of acute overdose with mepivacaine.
Averse experiences following the administration of mepivacaine are similar in nature to those observed with other amide local anaesthetic agents. These adverse experiences are, in general, dose related and may result from high plasma levels caused by excessive dosage, rapid absorption or unintended intravascular injection, or may result from a hypersensitivity, idiosyncrasy or diminished tolerace on the part of the patient. Serious adverse experiences are generally systematic in nature. Drowsiness following the administration of Mepivacaine is usually a sign of a high blood level of the drug and may occur as a consequence of rapid absorption. Cardiovascular manifestations are usually depressant and are characterized by bradycardia, hypotension, and cardiovascular collapse, which may lead to cardiac arrest.