Comparative Pharmacology
Head-to-head clinical analysis: NESACAINE versus XYLOCAINE VISCOUS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NESACAINE versus XYLOCAINE VISCOUS.
NESACAINE vs XYLOCAINE VISCOUS
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 blocks voltage-gated sodium channels, inhibiting nerve impulse propagation and reducing pain sensation.
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.
Adults: 5-15 mL orally (or swish and spit) 4-6 times daily, not to exceed 4 doses in 12 hours or 30 mL in 12 hours.
None Documented
None Documented
Terminal half-life: 40-60 minutes (rapidly metabolized by plasma pseudocholinesterase); clinical context: prolonged with hepatic dysfunction or atypical pseudocholinesterase
Terminal elimination half-life: 1.5-2 hours in adults; prolonged in hepatic impairment or heart failure (up to 6-8 hours). In neonates, half-life may be 3-6 hours due to immature metabolism.
Renal: 90-95% as unchanged drug and metabolites (predominantly 4-hydroxypropycaine); biliary/fecal: <5%
Renal excretion of metabolites: ~90%. Unchanged drug: <10%. Biliary/fecal: minor.
Category C
Category C
Local Anesthetic
Local Anesthetic