Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 4 IN DEXTROSE 5 versus MARCAINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 4 IN DEXTROSE 5 versus MARCAINE.
LIDOCAINE HYDROCHLORIDE 0.4% IN DEXTROSE 5% vs MARCAINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is a class IB antiarrhythmic agent that blocks voltage-gated sodium channels, inhibiting phase 0 depolarization and decreasing automaticity in ventricular myocardial cells. It also has local anesthetic properties by blocking nerve impulse conduction.
Bupivacaine blocks sodium ion channels in nerve cell membranes, inhibiting the generation and propagation of action potentials, resulting in local anesthesia.
Intravenous infusion: 1-4 mg/min (0.25-1 mL/min of 0.4% solution) after a loading dose of 1-1.5 mg/kg IV bolus for ventricular arrhythmias. Maximum total dose: 3 mg/kg.
Local infiltration: 0.25-0.5% solution, up to 30 mL; peripheral nerve block: 0.25-0.5% solution, 30-40 mL; epidural: 0.5-0.75% solution, 15-30 mL. Maximum dose: 2 mg/kg (with epinephrine), 1.5 mg/kg (without epinephrine).
None Documented
None Documented
Terminal elimination half-life is approximately 1.5-2 hours (mean 1.8 h) in healthy adults. In patients with hepatic impairment or heart failure, half-life may be prolonged to >3 hours. In neonates, half-life can be 3-6 hours.
Terminal elimination half-life: 2.5-4 hours in adults (longer in neonates and hepatic impairment; up to 8-12 hours). Clinically, accumulation occurs with continuous infusion or repeated doses.
Renal excretion of metabolites (primarily monoethylglycinexylidide and glycinexylidide) accounts for >90% of elimination. Less than 10% excreted unchanged in urine. Biliary/fecal excretion is negligible.
Renal excretion of metabolites (approximately 90-95% as para-aminobenzoic acid and other metabolites); less than 5% unchanged in urine. Biliary/fecal excretion is minimal.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic