Since 1885 every decade has had its popular local anesthetic agent. Witness the recent decades, when tetracaine hydrochloride (Pontocaine), lidocaine hydrochloride (Xylocaine) and hexylcaine hydrochloride (Cyclaine) rose successively to prominence and then receded into a niche of utility (Table 1). It is thus apparent that there remains an outstanding need in the practice of anesthesiology for the ideal agent. For the sake of completeness, the desirable characteristics of the ideal local anesthetic drug are listed (Table 2). Many drugs have been introduced to meet these specifications, but most fail in one respect or another. Many are being rapidly added to the list of potentially useful agents, and, indeed, it is difficult to evaluate them all thoroughly. However, as a result of the various screening studies and preliminary clinical testing we wish to recommend one drug, namely, mepivacaine hydrochloride (Carbocaine) with some confidence.
In the evaluation of this drug, 2 successive
COLLINS VJ, ROVENSTINE EA. Clinical Evaluation of Mepivacaine for Regional Anesthesia. Arch Surg. 1962;84(6):680-685. doi:10.1001/archsurg.1962.01300240084014