{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T23:17:00Z","timestamp":1779146220440,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,12,14]],"date-time":"2016-12-14T00:00:00Z","timestamp":1481673600000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australian Dental Journal"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Local anaesthetic\u2010related systemic toxicity mainly results from elevated plasma concentrations of these drugs. We hypothesized that intraoral injection of submaximal doses of mepivacaine does not lead to toxic levels of this drug in blood. This study evaluated the plasma levels of mepivacaine in third molars surgeries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010one patients were randomly assigned into two groups: group I (two unilateral third molars; submaximal dose of mepivacaine 108\u00a0mg with epinephrine 54\u00a0\u03bcg) and group <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> (four third molars; submaximal dose of mepivacaine 216\u00a0mg with epinephrine 108\u00a0\u03bcg). Blood samples were collected before anaesthesia, and 5, 10, 15, 20, 30, 40, 60, 90 and 120\u00a0min after anaesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Individual peak plasma concentrations ranged 0.77\u20138.31\u00a0\u03bcg\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> (group I) and from 2.36\u20137.72\u00a0\u03bcg\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> (group <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>). An increase in the average dose of mepivacaine from 1.88\u00a0\u00b1\u00a00.12\u00a0mg\/kg (group I) to 3.35\u00a0\u00b1\u00a00.17\u00a0mg\/kg (group <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>) increased the mean mepivacaine peak plasma levels from 2.33\u00a0\u00b1\u00a00.58 to 4.01\u00a0\u00b1\u00a00.69\u00a0\u03bcg\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>, respectively. Four patients obtained plasma levels of mepivacaine above the threshold for toxicity (5\u00a0\u03bcg\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Toxic levels of mepivacaine are possible, even when a submaximal dose is used. A twofold increase in the dose of mepivacaine caused the mean peak plasma concentration to increase proportionally, indicating that they may be predicted based on the relation of dose per bodyweight.<\/jats:p><\/jats:sec>","DOI":"10.1111\/adj.12410","type":"journal-article","created":{"date-parts":[[2016,1,18]],"date-time":"2016-01-18T14:37:54Z","timestamp":1453127874000},"page":"446-454","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Plasma mepivacaine concentrations in patients undergoing third molar surgery"],"prefix":"10.1111","volume":"61","author":[{"given":"HC","family":"Scarparo","sequence":"first","affiliation":[{"name":"Division of Clinical Pharmacology Department of Clinical Dentistry Federal University of Cear\u00e1 Cear\u00e1 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RN","family":"Maia","sequence":"additional","affiliation":[{"name":"Division of Oral and Maxillofacial Surgery Oral and Maxillofacial Surgery Residency Program Dr. Jos\u00e9 Frota Hospital Institute Cear\u00e1 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"EA dos Santos","family":"Filho","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Federal University of Cear\u00e1 Cear\u00e1 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ECS","family":"Soares","sequence":"additional","affiliation":[{"name":"Division of Oral and Maxillofacial Surgery Department of Clinical Dentistry Federal University of Cear\u00e1 Cear\u00e1 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"FWG","family":"Costa","sequence":"additional","affiliation":[{"name":"Division of Oral Radiology Department of Clinical Dentistry Federal University of Cear\u00e1 Cear\u00e1 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CSR","family":"Fonteles","sequence":"additional","affiliation":[{"name":"Division of Orthodontics and Pediatric Dentistry Department of Clinical Dentistry Federal University of Cear\u00e1 Cear\u00e1 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TP","family":"Bezerra","sequence":"additional","affiliation":[{"name":"Division of Oral and Maxillofacial Surgery Oral and Maxillofacial Surgery Residency Program Walter Cant\u00eddio Universitary Hospital Cear\u00e1 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TR","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Division of Orthodontics and Pediatric Dentistry Department of Clinical Dentistry Federal University of Cear\u00e1 Cear\u00e1 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NR","family":"Romero","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Federal University of Cear\u00e1 Cear\u00e1 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