Comparative Pharmacology
Head-to-head clinical analysis: LIDOCATON versus NESACAINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LIDOCATON versus NESACAINE.
LIDOCATON vs NESACAINE
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.
Nesacaine (chloroprocaine) is an ester-type local anesthetic that blocks voltage-gated sodium channels in neuronal membranes, inhibiting the initiation and conduction of nerve impulses.
Lidocaine: Initial IV bolus 1-1.5 mg/kg, then IV infusion 1-4 mg/min. Adjust for arrhythmia suppression.
Injectable local anesthetic: 1% or 2% solution, maximum dose 7 mg/kg (not to exceed 500 mg) with epinephrine, 4.5 mg/kg (not to exceed 300 mg) without epinephrine. Administer by infiltration or nerve block; may repeat at 30-minute intervals.
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 half-life: 40-60 minutes (rapidly metabolized by plasma pseudocholinesterase); clinical context: prolonged with hepatic dysfunction or atypical pseudocholinesterase
Renal: ~90% as metabolites (major metabolite 4-hydroxyxylidine) and ~10% unchanged. Biliary/fecal: <5%.
Renal: 90-95% as unchanged drug and metabolites (predominantly 4-hydroxypropycaine); biliary/fecal: <5%
Category C
Category C
Local Anesthetic
Local Anesthetic