Comparative Pharmacology
Head-to-head clinical analysis: LIDOCATON versus MARCAINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCATON versus MARCAINE.
LIDOCATON vs MARCAINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lidocaine is a class IB antiarrhythmic agent that blocks voltage-gated sodium channels, inhibiting the inward sodium current, thereby stabilizing cardiac membranes, decreasing automaticity, and increasing the fibrillation threshold. It also acts as a local anesthetic by reversibly blocking nerve impulse propagation.
Bupivacaine blocks sodium ion channels in nerve cell membranes, inhibiting the generation and propagation of action potentials, resulting in local anesthesia.
Lidocaine: Initial IV bolus 1-1.5 mg/kg, then IV infusion 1-4 mg/min. Adjust for arrhythmia suppression.
Local infiltration: 0.25-0.5% solution, up to 30 mL; peripheral nerve block: 0.25-0.5% solution, 30-40 mL; epidural: 0.5-0.75% solution, 15-30 mL. Maximum dose: 2 mg/kg (with epinephrine), 1.5 mg/kg (without epinephrine).
None Documented
None Documented
Terminal half-life 1.5–2 hours (adults); prolonged in heart failure (up to 4–6 hours) or hepatic impairment (up to 8 hours).
Terminal elimination half-life: 2.5-4 hours in adults (longer in neonates and hepatic impairment; up to 8-12 hours). Clinically, accumulation occurs with continuous infusion or repeated doses.
Renal: ~90% as metabolites (major metabolite 4-hydroxyxylidine) and ~10% unchanged. Biliary/fecal: <5%.
Renal excretion of metabolites (approximately 90-95% as para-aminobenzoic acid and other metabolites); less than 5% unchanged in urine. Biliary/fecal excretion is minimal.
Category C
Category C
Local Anesthetic
Local Anesthetic