Comparative Pharmacology
Head-to-head clinical analysis: LIDOCATON versus MARCAINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCATON versus MARCAINE HYDROCHLORIDE.
LIDOCATON vs MARCAINE HYDROCHLORIDE
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 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.
Lidocaine: Initial IV bolus 1-1.5 mg/kg, then IV infusion 1-4 mg/min. Adjust for arrhythmia suppression.
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 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 is approximately 2.5 to 3.5 hours in adults; may be prolonged in neonates (8-12 hours) or patients with hepatic impairment.
Renal: ~90% as metabolites (major metabolite 4-hydroxyxylidine) and ~10% unchanged. Biliary/fecal: <5%.
Primarily hepatic metabolism; less than 5% excreted unchanged in urine. Metabolites are excreted renally, with a small amount in feces via biliary elimination.
Category C
Category C
Local Anesthetic
Local Anesthetic