II. Preparations

  1. Lidocaine 0.5%, 1%, 2%

III. Pharmacokinetics

  1. Store at room Temperature (not in refrigerator)
    1. Reduces risk of infection with multi-use bottles
    2. Kirschke (2003) Clin Infect Dis 36:1369-73 [PubMed]
  2. Lidocaine alone (1%, 2%)
    1. Onset: 2 to 5 minutes
    2. Duration: 1.5 to 2 hours
    3. Max dose: 4 mg/kg to 280 mg (14 ml 2%, 28 ml 1%)
  3. Lidocaine with Epinephrine 1:100,000 or 1:200,000
    1. Onset: 2 minutes
    2. Duration: 2 to 6 hours
    3. Max dose: 7 mg/kg to 500 mg (25 ml 2%, 50 ml 1%)

IV. Dosing

  1. Intradermal Lidocaine
    1. See maximum dosing above
  2. Lidocaine Patch (indicated in Postherpetic Neuralgia)
    1. Apply to affected area every 4 to 12 hours as needed

V. Contraindications: Local Lidocaine use

  1. History of allergy to Local Anesthesia
  2. See Local Anesthetic for alternatives if allergy

VI. Contraindications: Combination with local Epinephrine use

  1. Digital Block
  2. Poor vascular supply to an avulsed area
  3. Dirty wound (risk of infection)
  4. Distal organs
    1. Fingers
    2. Nose
    3. Penis
    4. Toes
    5. Earlobes

VII. Preparations: Sodium Bicarbonate (Buffered Lidocaine)

  1. Indications
    1. Effective in reducing sting from Local Lidocaine
  2. Dilution 1:10 of 7.5% Sodium Bicarbonate in Xylocaine
  3. Preparation in Syringe (3.5 cc)
    1. Xylocaine: 3 cc
    2. Sodium Bicarbonate: 0.4 cc
  4. Precautions
    1. Shelf-life of Buffered Lidocaine reduced to 1 week

VIII. References

  1. Pfenninger (1994) Procedures, Mosby, p. 135-155
  2. Mortiere (1996) Wound Management, p. 27-39
  3. Achar (2002) Am Fam Physician 66(1):91-4 [PubMed]

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Ontology: Xylocaine (C0699094)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D008012
English local anesthetics lidocaine base (Xylocaine), lidocaine base (Xylocaine), xylocaine, Astrazeneca Brand of Lidocaine, Xylocaine

Ontology: Lidocaine Transdermal Patch (C1251704)

Definition (NCI) A transdermal patch containing a 5 percent aqueous base solution of the synthetic amide-type anesthetic lidocaine with analgesic activity. Upon topical application and transdermal delivery, the active ingredient lidocaine binds to and blocks voltage-gated sodium channels in the neuronal cell membrane; lidocaine-mediated stabilization of neuronal membranes inhibits the initiation and conduction of nerve impulses and produces a reversible local anesthesia.
Concepts Clinical Drug (T200)
English Lidocaine Transdermal Patch, Lidocaine Patch