Which type of local anesthetic would be appropriate for a patient with a recent myocardial infarction?

In the context of a patient with a recent myocardial infarction, the use of a local anesthetic that does not contain a vasoconstrictor, such as epinephrine, is crucial due to potential cardiovascular risks. Carbocaine, or mepivacaine, is often chosen in this scenario because it is available in a plain formulation, meaning it does not contain epinephrine.

Epinephrine can cause vasoconstriction which may increase cardiac workload and potentially lead to complications in patients with heart conditions. Given that the patient has experienced a myocardial infarction recently, avoiding any substances that could exacerbate heart issues is essential. Carbocaine plain allows for effective local anesthesia without the added risk associated with epinephrine, making it the most appropriate choice for this patient.

The other types of anesthetics listed either contain epinephrine or have formulations that could pose an increased risk to a patient with a compromised cardiovascular status. Therefore, the priority in selecting an anesthetic for such patients should focus on minimizing cardiovascular stress, which is effectively achieved with a plain anesthetic like Carbocaine.