Comparative Pharmacology
Head-to-head clinical analysis: NESACAINE versus XYLOCAINE 5 W GLUCOSE 7 5.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NESACAINE versus XYLOCAINE 5 W GLUCOSE 7 5.
NESACAINE vs XYLOCAINE 5% W/ GLUCOSE 7.5%
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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 is an amide-type local anesthetic that stabilizes the neuronal membrane by inhibiting sodium ion channels, thereby blocking the initiation and conduction of nerve impulses.
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.
Adult: 5-25 mL (250-1250 mg lidocaine) of 5% lidocaine with glucose 7.5% solution, administered by caudal or lumbar epidural injection, single dose. Max total dose: 1250 mg.
None Documented
None Documented
Terminal half-life: 40-60 minutes (rapidly metabolized by plasma pseudocholinesterase); clinical context: prolonged with hepatic dysfunction or atypical pseudocholinesterase
1.5-2 hours (terminal); prolonged in heart failure, hepatic disease, or elderly; neonates 3-6 hours due to immature hepatic function.
Renal: 90-95% as unchanged drug and metabolites (predominantly 4-hydroxypropycaine); biliary/fecal: <5%
Hepatic metabolism (90% N-dealkylation by CYP1A2/CYP3A4 to monoethylglycinexylidide and glycinexylidide); renal excretion of metabolites and parent drug (<10% unchanged); <1% biliary/fecal.
Category C
Category C
Local Anesthetic
Local Anesthetic