Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE versus NESACAINE MPF.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE versus NESACAINE MPF.
LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE vs NESACAINE-MPF
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is a sodium channel blocker that stabilizes neuronal membranes and inhibits action potentials, providing local anesthesia. Epinephrine is an alpha- and beta-adrenergic agonist that causes vasoconstriction, prolonging lidocaine's effect and reducing systemic absorption.
Nesacaine-MPF (chloroprocaine) is an ester-type local anesthetic that stabilizes neuronal membranes by inhibiting sodium ion influx, thereby blocking impulse conduction in nerve fibers.
Local anesthesia: 1% or 2% solution with epinephrine 1:100,000 or 1:200,000; maximum dose 7 mg/kg lidocaine (500 mg) in adults; administer by infiltration or nerve block, not to exceed 1 hour between doses.
1% solution: 2.5-30 mL (25-300 mg) subcutaneously or locally; maximum 30 mL per dose. 2% solution: 1.25-15 mL (25-300 mg) subcutaneously or locally; maximum 15 mL per dose.
None Documented
None Documented
Lidocaine: terminal elimination half-life is approximately 1.5–2.0 hours. With continuous infusion or hepatic impairment, half-life may be prolonged (up to 4–6 hours). Epinephrine: plasma half-life is about 2–3 minutes due to rapid uptake and metabolism.
Terminal half-life: 3-4 hours (adults); prolonged in hepatic or renal impairment.
Lidocaine is primarily metabolized in the liver; approximately 90% of a dose is excreted in the urine as metabolites (including monoethylglycinexylidide and glycinexylidide), with less than 10% excreted unchanged. Epinephrine is metabolized by catechol-O-methyltransferase and monoamine oxidase, with metabolites excreted in urine.
Renal excretion of metabolites; <10% unchanged drug. Biliary/fecal elimination minor.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic