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NERVOUS SYSTEM › ANESTHETICS › ANESTHETICS, LOCAL › Amides
etidocaine
N01BB07
Forms & Strengths
- Injectable solution: 1% with epinephrine 1:200,000
- Injectable solution: 1.5% with epinephrine 1:200,000
Adult Dosing
- Infiltration/Peripheral nerve block: Max 4 mg/kg (up to 300 mg) without epinephrine, or 5 mg/kg (up to 400 mg) with epinephrine 1:200,000
- Epidural block: 1.5% solution, 10 to 30 mL (150 to 450 mg) depending on the desired level of anesthesia
Pediatric Dosing
- Safety and efficacy in children under 12 years of age have not been established
- Use in pediatric patients is generally not recommended due to lack of clinical data
Indications
- Production of local or regional anesthesia by infiltration techniques
- Peripheral nerve blocks
- Central neural blocks (epidural anesthesia)
Mechanism of Action
- Amide-type local anesthetic
- Reversibly stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses
- Blocks both sodium and potassium ion channels in nerve fibers
Contraindications
- Known hypersensitivity to local anesthetics of the amide type
- Severe degrees of atrioventricular block without a pacemaker
- Intravenous regional anesthesia (Bier block) due to risk of systemic toxicity
- Inflamed or infected sites for local infiltration
Adverse Reactions
- Central nervous system toxicity: CNS excitation, nervousness, dizziness, blurred vision, tremors, convulsions, CNS depression, coma
- Cardiovascular toxicity: Myocardial depression, hypotension, bradycardia, ventricular arrhythmias, cardiac arrest
- Allergic reactions: Urticaria, angioedema, bronchospasm, anaphylactoid reactions
- Neurological: Persistent sensory or motor deficit, arachnoiditis (with spinal/epidural use)
Drug Interactions
- Class I antiarrhythmic drugs (e.g., tocainide, mexiletine): Additive toxic effects
- Sedatives and CNS depressants: Increased risk of central nervous system depression
- Neuromuscular blocking agents: Prolongation and enhancement of neuromuscular blockade
- Vasopressors (when combined with epinephrine): Severe persistent hypertension or cerebrovascular accidents
Curated Content: Needs Vetting Before Put to Clinical Use