Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 8 IN DEXTROSE 5 IN PLASTIC CONTAINER versus NESACAINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 0 8 IN DEXTROSE 5 IN PLASTIC CONTAINER versus NESACAINE.
LIDOCAINE HYDROCHLORIDE 0.8% IN DEXTROSE 5% IN PLASTIC CONTAINER vs NESACAINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is an amide-type local anesthetic that acts by blocking voltage-gated sodium channels in neuronal cell membranes, thereby inhibiting the initiation and conduction of nerve impulses. This stabilizes the neuronal membrane and produces a reversible loss of sensation.
Nesacaine (chloroprocaine) is an ester-type local anesthetic that blocks voltage-gated sodium channels in neuronal membranes, inhibiting the initiation and conduction of nerve impulses.
Intravenous administration: 1-1.5 mg/kg bolus, followed by 1-4 mg/min continuous infusion for ventricular arrhythmias. Max dose: 3 mg/kg bolus, 4 mg/min infusion.
Injectable local anesthetic: 1% or 2% solution, maximum dose 7 mg/kg (not to exceed 500 mg) with epinephrine, 4.5 mg/kg (not to exceed 300 mg) without epinephrine. Administer by infiltration or nerve block; may repeat at 30-minute intervals.
None Documented
None Documented
Terminal elimination half-life is approximately 1.5–2.0 hours after a single IV dose. In patients with heart failure or hepatic impairment, it may be prolonged to >3 hours. After continuous infusion, the half-life may increase due to accumulation.
Terminal half-life: 40-60 minutes (rapidly metabolized by plasma pseudocholinesterase); clinical context: prolonged with hepatic dysfunction or atypical pseudocholinesterase
Lidocaine is primarily metabolized in the liver by CYP1A2 and CYP3A4 to active metabolites (MEGX, GX). Less than 10% is excreted unchanged in urine. Renal excretion accounts for about 20% of total clearance as metabolites and parent drug; fecal elimination is minimal (<5%).
Renal: 90-95% as unchanged drug and metabolites (predominantly 4-hydroxypropycaine); biliary/fecal: <5%
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic