Comparative Pharmacology
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE W EPINEPHRINE versus SENSORCAINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCAINE HYDROCHLORIDE W EPINEPHRINE versus SENSORCAINE.
LIDOCAINE HYDROCHLORIDE W/ EPINEPHRINE vs SENSORCAINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is a sodium channel blocker that inhibits voltage-gated sodium channels, preventing depolarization and conduction of nerve impulses. Epinephrine is an alpha- and beta-adrenergic agonist that causes vasoconstriction, reducing systemic absorption of lidocaine and prolonging local anesthetic effect.
SENSORCAINE (bupivacaine) is an amide-type local anesthetic that blocks sodium ion channels in nerve cell membranes, thereby inhibiting depolarization and propagation of action potentials, resulting in reversible local anesthesia.
Local anesthesia: 1-5 mL of 1% or 2% solution with epinephrine 1:100,000 or 1:200,000; maximum dose 7 mg/kg lidocaine (500 mg without epinephrine, 7 mg/kg with epinephrine) per procedure. Intravenous: 1-1.5 mg/kg bolus for ventricular arrhythmias, followed by continuous infusion 1-4 mg/min.
Epidural or caudal block: 15-30 mL of 0.5% to 1% solution (75-150 mg) every 2-4 hours as needed. Maximum single dose: 225 mg.
None Documented
None Documented
Terminal half-life 1.5-2 hours (single dose), prolonged to 2-3 hours with continuous infusion; in heart failure or hepatic cirrhosis, half-life may exceed 5 hours.
The terminal elimination half-life of bupivacaine is approximately 2.7 hours in adults (range 1.5–5.5 hours). In neonates, the half-life is significantly prolonged (~8–12 hours) due to immature hepatic function, leading to an increased risk of toxicity.
Renal: unchanged drug <10%, major metabolites (MEGX and GX) ~70% renal; biliary: <10% fecal; total clearance ~10-20 mL/min/kg. Renal impairment prolongs elimination of metabolites.
SENSORCAINE (bupivacaine) is primarily metabolized in the liver via conjugation with glucuronic acid and undergoes hepatic dealkylation. Approximately 6% of the drug is excreted unchanged in the urine. The majority of the dose (about 95%) is excreted as metabolites in the urine (<10% unchanged) and the remainder in feces via biliary elimination.
Category A/B
Category C
Local Anesthetic / Antiarrhythmic (Class Ib)
Local Anesthetic