Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 4 AND DEXTROSE 5 IN PLASTIC CONTAINER versus MARCAINE HYDROCHLORIDE PRESERVATIVE FREE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 4 AND DEXTROSE 5 IN PLASTIC CONTAINER versus MARCAINE HYDROCHLORIDE PRESERVATIVE FREE.
LIDOCAINE HYDROCHLORIDE 0.4% AND 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 amide-type local anesthetic that blocks voltage-gated sodium channels in neuronal membranes, inhibiting the initiation and conduction of nerve impulses. Dextrose provides calories and does not have pharmacological activity.
Bupivacaine blocks sodium ion channels in nerve cell membranes, preventing the generation and conduction of nerve impulses, resulting in local anesthesia.
Intravenous administration: 1-1.5 mg/kg bolus, followed by 1-4 mg/min continuous infusion for ventricular arrhythmias. Maximum total dose: 3 mg/kg bolus; infusion for up to 24 hours. Note: 0.4% concentration = 4 mg/mL, 5% dextrose as diluent.
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: 1.5–2 hours after a single dose in healthy adults. In patients with hepatic impairment, heart failure, or prolonged infusion, half-life can increase to >3 hours due to reduced clearance. Neonates: 3–6.3 hours.
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: Approximately 90% of lidocaine is metabolized in the liver, and less than 10% is excreted unchanged in urine. The major metabolites (monoethylglycinexylidide and glycinexylidide) are excreted renally. 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