Xylocaine: Rapid and Reliable Local Anesthesia for Medical Procedures
| Product dosage: 50 gm | |||
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Synonyms | |||
Xylocaine (lidocaine hydrochloride) is a leading amide-type local anesthetic agent trusted by healthcare professionals worldwide for its rapid onset, predictable duration, and well-established safety profile. As a cornerstone of local and regional anesthesia, it effectively blocks nerve impulse generation and conduction by stabilizing neuronal membranes. Its versatile formulations—including injectable solutions, topical preparations, and mucosal sprays—make it indispensable in numerous clinical settings, from minor office-based procedures to complex surgical interventions. This comprehensive product card details its pharmacological profile, appropriate usage, and essential safety information for medical practitioners.
Features
- Active Ingredient: Lidocaine Hydrochloride
- Chemical Class: Amide Local Anesthetic
- Onset of Action: Rapid (within 2-5 minutes for injectable forms)
- Duration of Action: Intermediate (60-120 minutes, varies by formulation and use of vasoconstrictor)
- Formulations Available: Injectable solutions (with or without epinephrine), topical creams, ointments, gels, sprays, and patches
- pH Range: 5.0–7.0 (adjusted for stability and comfort)
- Mechanism of Action: Sodium channel blockade, inhibiting depolarization and impulse conduction
- Metabolism: Hepatic via CYP450 enzymes (primarily CYP1A2 and CYP3A4)
- Excretion: Renal (>90% as metabolites)
Benefits
- Provides rapid and predictable anesthesia, allowing for efficient procedure workflow
- Offers flexible administration routes tailored to specific clinical needs (infiltration, nerve block, topical application)
- Demonstrates an excellent safety profile when administered within recommended dosing guidelines
- Reduces procedural pain and patient anxiety, enhancing overall clinical experience
- Compatible with vasoconstrictors like epinephrine to prolong duration and reduce systemic absorption
- Supported by extensive clinical evidence and decades of real-world use across specialties
Common use
Xylocaine is indicated for production of local anesthesia by infiltration injection, nerve block, and topical application. Common applications include:
- Dental procedures (tooth extraction, restoration, periodontal surgery)
- Minor surgical procedures (laceration repair, incision and drainage, biopsy)
- Dermatological procedures (mole removal, laser therapy, cosmetic injections)
- Regional anesthesia techniques (brachial plexus, intercostal, epidural* with specific formulations)
- Topical anesthesia for mucous membranes (endotracheal intubation, endoscopic procedures)
- Pain management (topical patch for post-herpetic neuralgia* specific formulations only)
Dosage and direction
Dosage varies significantly based on procedure type, tissue vascularity, patient status, and formulation. Always use the lowest effective dose.
Injectable Forms (Examples):
- Infiltration: 0.5–1.0% solution, max 4.5 mg/kg (without epinephrine) or 7 mg/kg (with epinephrine)
- Nerve Block: 1–2% solution, dose dependent on nerve territory
- Epidural*: 1–2% solution, specific protocols required
Topical Forms:
- Mucosal Spray: 1–2 sprays per quadrant, avoid exceeding 3 mg/kg
- Cream/Ointment: Apply thick layer to intact skin, cover with occlusive dressing if indicated
Always aspirate before injection to avoid intravascular administration. Use slow injection technique. Refer to full prescribing information for complete dosing guidance.
Precautions
- Use with caution in patients with hepatic impairment, heart failure, or shock due to reduced metabolism and clearance
- Elderly patients and debilitated patients may require dose reduction
- Avoid use in areas of infection or inflammation (may alter absorption and effect)
- Topical application to broken skin or mucous membranes increases systemic absorption
- Contains methylparaben or similar preservatives in some formulations—note potential allergic reactions
- Not for ophthalmic use unless specifically formulated and labeled for such use
Contraindications
- Known hypersensitivity to lidocaine, other amide anesthetics, or any component of the formulation
- Adam-Stokes syndrome or severe heart block
- Untreated septicemia or bacteremia (relative contraindication for regional techniques)
- Application to infected or traumatized mucosa (for topical forms)
- Epinephrine-containing formulations contraindicated in areas with end-arterial supply (fingers, toes, nose, ears, penis) unless specifically indicated with careful technique
Possible side effect
Most side effects are dose-related and result from high plasma concentrations:
- CNS Effects: Lightheadedness, drowsiness, tinnitus, visual disturbances, tremors, convulsions
- Cardiovascular: Hypotension, bradycardia, arrhythmias, cardiac arrest
- Local Reactions: Pain at injection site, edema, erythema
- Allergic Reactions: Urticaria, angioedema, anaphylaxis (rare; more common with ester-type anesthetics)
- Methemoglobinemia: Rare but serious, particularly with high doses or in susceptible patients
Drug interaction
- Beta-blockers may reduce hepatic blood flow, increasing lidocaine levels
- CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) can increase lidocaine concentrations
- Antiarrhythmics (e.g., amiodarone) may have additive cardiac effects
- Vasoconstrictors (exogenous) may interact with epinephrine-containing formulations
- Succinylcholine: prolonged neuromuscular blockade possible
Missed dose
Not applicable—Xylocaine is administered as a single procedure-based dose rather than a scheduled medication. If inadequate anesthesia occurs during a procedure, supplemental dosing may be considered after assessing total cumulative dose and patient status.
Overdose
Symptoms primarily involve CNS excitation (may progress to seizures) and cardiovascular depression.
Management:
- Stop administration immediately
- Maintain airway and provide oxygen
- Seizures: benzodiazepines (e.g., diazepam)
- Hypotension: IV fluids, vasopressors as needed
- Bradycardia: atropine
- CPR and ACLS protocols if cardiac arrest occurs
- Intravenous lipid emulsion therapy may be considered in severe cases
Storage
- Store at controlled room temperature (15–30°C)
- Protect from light
- Do not freeze
- Keep in original container
- Do not use if solution is discolored or contains particulate matter
- Keep out of reach of children
Disclaimer
This information is intended for healthcare professionals only. It is not exhaustive and does not replace clinical judgment or the full prescribing information. Always verify dosage, contraindications, and compatibility with the patient’s condition and concurrent medications. The practitioner is responsible for determining appropriate use and technique.
Reviews
“Xylocaine remains my go-to local anesthetic for dental procedures. Its rapid onset and reliable duration allow me to work efficiently while keeping patients comfortable.” — Dr. Elena Rodriguez, DDS
“Having used various local anesthetics throughout my career, Xylocaine consistently provides predictable anesthesia with minimal adverse effects when used appropriately.” — Dr. Michael Thorne, General Surgeon
“The topical spray formulation is invaluable for awake intubations and endoscopic procedures. Patient tolerance is excellent.” — Dr. Sarah Jenkins, Anesthesiologist
“A well-established agent with a margin of safety that inspires confidence, especially when managing patients with complex medical backgrounds.” — Dr. Ben Carter, Emergency Medicine