Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE versus POLOCAINE MPF.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE versus POLOCAINE MPF.
LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE vs POLOCAINE-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.
Polocaine-MPF (mepivacaine hydrochloride) is an amide-type local anesthetic that blocks sodium ion channels in nerve cell membranes, thereby preventing the initiation and propagation of nerve impulses. This results in reversible loss of sensation in the area of administration.
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.
Adults: 1-2 cartridges (1.8 mL each) of 2% lidocaine with 1:100,000 epinephrine administered via local infiltration or nerve block, not to exceed 7 mg/kg (maximum 500 mg) for lidocaine.
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 elimination half-life: 1.5-2.0 hours in adults; prolonged in hepatic impairment (up to 4-6 hours) and severe renal impairment. Clinical context: short half-life supports continuous infusion for sustained effect.
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: >90% as metabolites, primarily 4-hydroxy-2',6'-dimethylacetanilide and pipecoloxylidide; unchanged drug <5%. Biliary/fecal: <5%.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic