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White crystalline powder
Local anesthesic;Na+ channel blocker; Anesthetic (local); antiarrhythmic (class IB). Long-acting, membrane stabilizing agent against ventricular arrhythmia. Originally developed as a local anesthetic.
Description and Application:
Lidocaine hydrochloride is a white powder without smell and with a bitter taste that is used both in
human and veterinary medicine. The drug is also known as lignocaine hydrochloride, and is used as
a local anesthetic and to regulate certain medical problems related to heart rhythm. Injections of it are used to provide local anesthesia during various minor surgical procedures. It is also available in
various topical preparations, such as gels, sprays, creams, and ointments that are usually applied to
the skin or the mucous membranes. This drug was first manufactured in Sweden in 1943 and was then named xylocaine.
The efficacy profile of lidocaine as a local anesthetic is characterized by a rapid onset of action and
intermediate duration of efficacy. Therefore, lidocaine is suitable for infiltration, block and surface
anesthesia. Longer-acting substances such as bupivacaine are sometimes given preference for
subdural and epidural anesthesias; lidocaine, on the other hand, has the advantage of a rapid onset
of action. Epinephrine (aka adrenaline) vasoconstricts arteries reducing bleeding and also delays
the resorption of lidocaine, almost doubling the duration of anaesthesia. For surface anesthesia
several formulations are available that can be used e.g. for endoscopies, before intubations etc.
Buffering the pH of lidocaine makes local freezing less painful. Lidocaine drops can be used on the
eyes for short ophthalmic procedures.
Topical lidocaine has been shown in some patients to relieve the pain of postherpetic neuralgia (a
complication of shingles), though there is not enough study evidence to recommend it as a
first-line treatment. IV lidocaine also has uses as a temporary fix for tinnitus. Although not
completely curing the disorder, it has been shown to reduce the effects by around two thirds. Lidocaine hydrochloride injection administered intravenously or intramuscularly, is specifically
indicated in the acute management of ventricular arrhythmias such as those occurring in relation
to acute myocardial infarction, or during cardiac manipulation, such as cardiac surgery.
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