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NERVOUS SYSTEM › ANESTHETICS › ANESTHETICS, LOCAL › Amides
lidocaine, combinations
N01BB52
Forms & Strengths
- Lidocaine 20mg + Epinephrine 12.5mcg/mL injection
- Lidocaine 50mg + Epinephrine 5mcg/mL injection
- Lidocaine 20mg/mL injection with epinephrine
- Lidocaine HCl 2% solution with epinephrine 1:50,000
Adult Dosing
- Local anesthesia: 0.5-1 mL (5-10 mg) per procedure
- Infiltration anesthesia: 1-60 mL (10-600 mg) per procedure
- Regional anesthesia: dose varies by location and procedure
- Not to exceed 4.5 mg/kg (without epinephrine) or 7 mg/kg (with epinephrine)
Pediatric Dosing
- Local anesthesia: 0.5-1 mL (5-10 mg) per procedure for children over 3 years
- Infiltration anesthesia: 0.5-1 mL (5-10 mg) per procedure for children over 3 years
- Regional anesthesia: dose varies by location, procedure, and weight
- Not to exceed 4.5 mg/kg (without epinephrine) or 7 mg/kg (with epinephrine) in pediatric patients
Indications
- Production of local or regional anesthesia
- Localized anesthesia for minor surgical procedures
- Pain relief in minor procedures, including dental and skin procedures
Mechanism of Action
- Blocks sodium channels in neuronal membranes, preventing depolarization and pain signal transmission
- Produces a rapid, reversible block of nerve conduction
- Inhibition of nerve signal conduction leads to numbness and loss of sensation in the targeted area
Contraindications
- Hypersensitivity to lidocaine or other amide local anesthetics
- Heartblock (second or third degree) with no artificial pacemaker
- Severe shock or heart failure
- Local infection at the injection site
Adverse Reactions
- Numbness, tingling, and dizziness
- Allergic reactions such as hives, redness, and itching
- Cardiovascular effects such as hypotension and cardiac arrhythmias
- Methemoglobinemia and CNS toxicity at high doses
Drug Interactions
- Increased toxicity with beta blockers, cimetidine, and other anti-arrhythmics
- Interacts with epinephrine to prolong action of lidocaine
- Potentiated by concomitant use of succinylcholine
- May interact with MAOIs and tricyclic antidepressants to increase risk of toxicity
Curated Content: Needs Vetting Before Put to Clinical Use