Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 5 AND DEXTROSE 7 5 versus MARCAINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE 5 AND DEXTROSE 7 5 versus MARCAINE HYDROCHLORIDE.
LIDOCAINE HYDROCHLORIDE 5% AND DEXTROSE 7.5% vs MARCAINE HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine stabilizes the neuronal membrane by inhibiting sodium ion influx, thereby blocking the initiation and conduction of nerve impulses. Dextrose provides caloric support.
Bupivacaine is an amide-type local anesthetic that blocks voltage-gated sodium channels in nerve cell membranes, reversibly inhibiting nerve impulse propagation, particularly in sensory fibers.
For IV administration, typical adult dose is 5-7 mg/kg intravenously as a single bolus, followed by 0.5-1 mg/kg every 5-10 minutes as needed, up to a maximum total dose of 200-300 mg. For epidural or caudal anesthesia, 15-20 mL of the 5% solution provides adequate block. For peripheral nerve block, 10-30 mL. Do not exceed 5 mg/kg per dose intravenously or 300 mg per dose by infiltration.
Adults: 0.5% solution infiltrated up to 175 mg (35 mL) for minor procedures; for major procedures, up to 225 mg (45 mL) with epinephrine. Repeat doses at 3-hour intervals. Maximum dose 400 mg with epinephrine.
None Documented
None Documented
Terminal elimination half-life is approximately 1.5 to 2 hours in healthy adults after intravenous administration. In patients with heart failure or hepatic impairment, half-life may be prolonged to 4-6 hours or more. After epidural administration, half-life may be slightly longer due to ongoing absorption.
Terminal elimination half-life is approximately 2.5 to 3.5 hours in adults; may be prolonged in neonates (8-12 hours) or patients with hepatic impairment.
Renal excretion of unchanged lidocaine and metabolites; less than 10% excreted unchanged in urine. Hepatic metabolism produces active metabolites (MEGX, GX) which are renally excreted. Biliary/fecal excretion negligible.
Primarily hepatic metabolism; less than 5% excreted unchanged in urine. Metabolites are excreted renally, with a small amount in feces via biliary elimination.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic