Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 4 AND DEXTROSE 5 IN PLASTIC CONTAINER versus PROCAINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 4 AND DEXTROSE 5 IN PLASTIC CONTAINER versus PROCAINE HYDROCHLORIDE.
LIDOCAINE HYDROCHLORIDE 0.4% AND DEXTROSE 5% IN PLASTIC CONTAINER vs PROCAINE HYDROCHLORIDE
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.
Blocks voltage-gated sodium channels, inhibiting nerve impulse conduction by stabilizing the neuronal membrane and preventing depolarization.
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: 0.5% solution, up to 200 mg (40 mL) per dose. Nerve block: 0.5% solution, 100-200 mg (20-40 mL) per dose. Intravenous regional anesthesia (Bier block): 0.5% solution, 50-100 mg (10-20 mL) per dose. Maximum total dose: 200 mg without epinephrine, 250 mg with epinephrine 1:200,000.
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 is approximately 7.7 minutes in adults with normal hepatic function. This short half-life reflects rapid hydrolysis by plasma pseudocholinesterases. In patients with pseudocholinesterase deficiency, half-life may be prolonged to 20-30 minutes.
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 renal excretion of metabolites (para-aminobenzoic acid and diethylaminoethanol) and unchanged drug. Approximately 80% of a dose is excreted in urine as para-aminobenzoic acid and conjugates; <2% excreted unchanged. Biliary/fecal elimination is negligible.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic