Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 2 IN DEXTROSE 5 IN PLASTIC CONTAINER versus MARCAINE HYDROCHLORIDE PRESERVATIVE FREE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 2 IN DEXTROSE 5 IN PLASTIC CONTAINER versus MARCAINE HYDROCHLORIDE PRESERVATIVE FREE.
LIDOCAINE HYDROCHLORIDE 0.2% IN DEXTROSE 5% IN PLASTIC CONTAINER vs MARCAINE HYDROCHLORIDE PRESERVATIVE FREE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is a sodium channel blocker that stabilizes the neuronal membrane by inhibiting the ionic fluxes required for initiation and conduction of impulses, resulting in local anesthetic and antiarrhythmic effects.
Bupivacaine blocks sodium ion channels in nerve cell membranes, preventing the generation and conduction of nerve impulses, resulting in local anesthesia.
Intravenous infusion: 1-4 mg/min (0.2% solution = 2 mg/mL) for antiarrhythmic therapy; loading dose 1-1.5 mg/kg IV bolus, then infusion. Maximum infusion rate 4 mg/min.
Local infiltration: up to 30 mL of 0.5% (150 mg) per dose. Peripheral nerve block: 30-40 mL of 0.5% (150-200 mg). Epidural: 15-20 mL of 0.5% (75-100 mg). Maximum single dose: 2.5 mg/kg (225 mg for 90 kg). Repeat doses after 3 hours, max 400 mg/24h.
None Documented
None Documented
Terminal elimination half-life is approximately 1.5–2 hours (mean 1.8 h) in adults with normal hepatic function; may be prolonged in patients with hepatic impairment (e.g., cirrhosis) or heart failure (up to 10 h), and in neonates (3–6 h).
Terminal elimination half-life in adults: 2.7 ± 1.2 hours (range 1.5-5.5 hours). In neonates, half-life is prolonged to approximately 8.1 ± 8.2 hours due to immature hepatic and renal function.
Renal excretion of unchanged drug and metabolites accounts for >95% of elimination, with ~10% as unchanged lidocaine and ~90% as metabolites (primarily 4-hydroxy-2,6-xylidine, with minor contribution from monoethylglycinexylidide and glycinexylidide). Biliary/fecal excretion is minimal (<1%).
Primarily hepatic metabolism to 2,6-pipecoloxylidide (PPX) and subsequent renal excretion. Renal excretion of unchanged bupivacaine accounts for approximately 5-10% of the dose. The remainder is eliminated as metabolites (PPX and others) in urine. Fecal excretion is negligible.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic