title: The Effects of Mepivacaine Hydrochloride on Antimicrobial Activity and Mechanical Nociceptive Threshold During Amikacin Sulfate Regional Limb Perfusion in the Horse.
abstract: OBJECTIVE
  To determine the effect of intravenous regional limb perfusion (IVRLP) with a combination of mepivacaine hydrochloride and amikacin sulfate on synovial fluid amikacin sulfate concentration, antimicrobial activity, and mechanical nociceptive threshold (MNT).
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  Healthy adult horses (n=9).
  
  
  METHODS
  One IVRLP treatment was randomly administered by cephalic vein of each limb: amikacin alone (1 g amikacin in 60 mL saline) or amikacin with mepivacaine (1 g amikacin and 500 mg mepivacaine in 60 mL saline). Opposite treatments were repeated after a 24 hour wash-out period. Amikacin concentration and antimicrobial activity were determined for synovial fluid from middle carpal joints at tourniquet removal and 30 minutes following. Zone of inhibition was determined for Staphylococcus aureus and Escherichia coli. MNT was determined at 3 dorsal metacarpal locations prior to and after sedation, after Esmarch tourniquet application, and 30 minutes after IVRLP prior to and after tourniquet removal.
  
  
  RESULTS
  Two limbs from each treatment group were removed because of undetectable amikacin concentrations for a total of 14 data sets analyzed. Synovial fluid amikacin concentrations and zone of inhibition were not significantly different between treatments at any time point. MNT were significantly increased 30 minutes after IVRLP prior to and following tourniquet removal using amikacin and mepivacaine (median, range; 40.0 µg/mL, 38.7-40.0 and 40.0, 25.8-40.0, respectively) compared to amikacin alone (19.5 µg/mL, 18.7-25.6 and 15.3, 13.2-20.5, respectively).
  
  
  CONCLUSIONS
  Addition of mepivacaine to amikacin for IVRLP in the horse as a means of providing analgesia without decreasing antimicrobial activity.
authors.affiliation: Department of Orthopaedic Research Center, Colorado State University, College of Veterinary Medicine, Fort Collins, Colorado.
authors.forename: Aimée C
authors.initials: AC
authors.lastname: Colbath
authors.affiliation: Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine, Fort Collins, Colorado.
authors.forename: Luke A
authors.initials: LA
authors.lastname: Wittenburg
authors.affiliation: Department of Clinical Sciences, Washington State University, College of Veterinary Medicine, Pullman, Washington.
authors.forename: Jenifer R
authors.initials: JR
authors.lastname: Gold
authors.affiliation: Department of Orthopaedic Research Center, Colorado State University, College of Veterinary Medicine, Fort Collins, Colorado.
authors.forename: C Wayne
authors.initials: CW
authors.lastname: McIlwraith
authors.affiliation: Department of Orthopaedic Research Center, Colorado State University, College of Veterinary Medicine, Fort Collins, Colorado.
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Moorman
mesh_terms: D000583:Amikacin / Q000008:administration & dosage* / Q000737:chemistry / Q000494:pharmacology*; D000779:Anesthetics, Local / Q000493:pharmacokinetics / Q000494:pharmacology; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000737:chemistry / Q000494:pharmacology; D004347:Drug Interactions; D005552:Forelimb / Q000098:blood supply; D006736:Horses; D007262:Infusions, Intravenous; D008619:Mepivacaine / Q000493:pharmacokinetics* / Q000494:pharmacology; D010146:Pain / Q000517:prevention & control*; D010477:Perfusion / Q000662:veterinary*; D013582:Synovial Fluid / Q000737:chemistry; D014111:Tourniquets / Q000662:veterinary; D014656:Vascular Surgical Procedures
chemical_list: D000779:Anesthetics, Local; D000900:Anti-Bacterial Agents; D000583:Amikacin; D008619:Mepivacaine