Xylocaine: Expert Local Anesthesia for Procedural Pain Control
| Product dosage: 50 gm | |||
|---|---|---|---|
| Package (num) | Per tube | Price | Buy |
| 8 | $6.31
Best per tube | $72.66 $50.45 (31%) | 🛒 Add to cart |
| 10 | $9.08 | $90.82 (0%) | 🛒 Add to cart |
Synonyms | |||
Xylocaine (lidocaine hydrochloride) is a premier amide-type local anesthetic agent trusted by medical professionals worldwide for its rapid onset, reliable depth, and predictable duration of action. It is indicated for the production of local anesthesia by nerve block, infiltration, and topical application techniques. Its well-established pharmacokinetic profile and extensive clinical history make it a cornerstone in both hospital and outpatient settings for a wide range of diagnostic and therapeutic procedures, ensuring patient comfort and facilitating successful medical interventions.
Features
- Active Pharmaceutical Ingredient: Lidocaine Hydrochloride.
- Available in multiple formulations: injectable solutions (with or without epinephrine), ointments, jellies, and topical sprays.
- Standard injectable concentrations include 0.5%, 1%, and 2%.
- Epinephrine-containing formulations (e.g., 1:100,000 or 1:200,000) provide vasoconstriction for prolonged duration and reduced systemic absorption.
- Rapid onset of action, typically within 2-5 minutes for infiltration anesthesia.
- Intermediate duration of anesthetic effect, variable based on formulation and technique.
Benefits
- Provides rapid and effective analgesia, allowing for pain-free performance of minor surgical, dental, and diagnostic procedures.
- Enhances patient cooperation and comfort, reducing anxiety associated with painful interventions.
- The availability of epinephrine-containing formulations minimizes surgical bleeding by producing local vasoconstriction.
- Reduces systemic analgesic requirements post-procedure by establishing a solid foundational block.
- Its versatility across infiltration, nerve block, and topical applications offers flexibility in clinical planning.
- A well-understood safety profile allows for predictable management and risk mitigation.
Common use
Xylocaine is routinely employed for local anesthesia across numerous medical specialties. Its applications include, but are not limited to: suturing of lacerations; incision and drainage of abscesses; dental procedures such as restorations and extractions; as a spinal anesthetic for lower abdominal and limb surgeries; topical anesthesia for mucosal surfaces prior to endoscopic procedures or intubation; and nerve blocks for regional anesthesia of specific anatomical areas. It is a fundamental tool in emergency medicine, dermatology, dentistry, gastroenterology, and anesthesiology.
Dosage and direction
Dosage is highly individualized and contingent upon the procedure type, tissue vascularity, area of application, and patient status (e.g., weight, physical condition). The smallest dose and lowest concentration that provides effective anesthesia should always be used.
- For Infiltration and Nerve Block: The maximum recommended dose for a healthy adult is 4.5 mg/kg (not to exceed 300 mg) of plain lidocaine. When combined with epinephrine, the maximum dose can be extended to 7 mg/kg (not to exceed 500 mg). Always aspirate before injection to avoid intravascular administration.
- Topical Use: Apply the recommended quantity (e.g., a thin layer of ointment or measured spray) to the desired area. Dosage is limited by the total surface area treated and absorption potential.
- Specific dosing guidelines for epidural, caudal, and spinal use are well-defined in anesthesiology literature and must be adhered to strictly.
- Crucially, the full prescribing information for the specific formulation and concentration must be consulted prior to every administration.
Precautions
Administration requires caution and clinical vigilance. Use with extreme care in patients with severe shock, heart block, or impaired cardiac conduction. Dosage reduction is necessary for debilitated, elderly, or acutely ill patients, and for those with impaired liver function or reduced hepatic blood flow, as metabolism may be decreased. Injections should be made slowly and with frequent aspirations. Resuscitative equipment and drugs, including oxygen and anticonvulsant medication (e.g., benzodiazepines), must be immediately available to manage potential adverse reactions.
Contraindications
Xylocaine is contraindicated in patients with a known history of hypersensitivity to local anesthetics of the amide type or to any other component of the formulation. Epinephrine-containing solutions are contraindicated for use in areas supplied by end-arteries (e.g., digits, nose, ears, penis) due to the risk of vasoconstriction-induced ischemia and necrosis, and in patients with uncontrolled hyperthyroidism or severe hypertension.
Possible side effect
Adverse reactions are generally dose-related and result from high plasma levels. Systemically, these may include:
- Central Nervous System: Nervousness, dizziness, blurred vision, tremors, drowsiness, convulsions, unconsciousness, and respiratory arrest.
- Cardiovascular System: Hypotension, bradycardia, arrhythmias, and cardiovascular collapse, which can be fatal.
- Allergic reactions (dermatological manifestations like urticaria, edema, and anaphylaxis) are rare but possible. Local reactions may include pain, tenderness, or erythema at the injection site.
Drug interaction
Xylocaine may interact with other drugs, potentially increasing the risk of adverse effects.
- Antiarrhythmics: Concurrent use with other Class I antiarrhythmic drugs (e.g., mexiletine, tocainide) may have additive cardiotoxic effects.
- Beta-blockers and Cimetidine may reduce hepatic blood flow, potentially increasing lidocaine plasma levels.
- Vasopressors: Use with other sympathomimetics may lead to severe hypertension or arrhythmias.
- CYP3A4 Inhibitors: Drugs like certain antifungals and antibiotics may inhibit lidocaine metabolism, increasing its concentration.
Missed dose
The concept of a “missed dose” is not applicable to Xylocaine, as it is administered as a single procedure-based treatment and not on a chronic, scheduled dosing regimen. Anesthesia is administered once, as needed for a specific intervention.
Overdose
Overdose occurs primarily from elevated plasma concentrations, leading to toxic systemic effects. Management is supportive and focuses on maintaining an airway and supporting ventilation with oxygen and assisted ventilation as needed. Seizure control is paramount and is typically managed with a benzodiazepine (e.g., diazepam, midazolam). Cardiovascular depression requires standard advanced cardiac life support (ACLS) protocols, including fluids and vasopressors. Intravenous lipid emulsion therapy has emerged as an effective adjuvant treatment for severe local anesthetic systemic toxicity (LAST).
Storage
Store at controlled room temperature (20°-25°C or 68°-77°F), protected from light. Do not freeze. Epinephrine-containing solutions are sensitive to oxidation; inspect for discoloration (pinkish or darker than slightly yellow) or precipitation before use, and discard if present. Keep all preparations out of reach of children.
Disclaimer
This information is for educational and professional reference purposes only and does not constitute medical advice. It is not a substitute for the official prescribing information or the professional judgment of a qualified healthcare provider. The practitioner must rely on their own clinical experience and knowledge of the patient to determine the best course of treatment and appropriate dosages. Full prescribing information, including boxed warnings, must be reviewed prior to administration.
Reviews
- “The gold standard for infiltration anesthesia in the ED. Its predictable onset and duration make procedural sedation unnecessary for many laceration repairs.” – Emergency Medicine Physician, 15 years experience.
- “A versatile and reliable agent for both topical and injectable use in dermatologic surgery. The different formulations allow for tailored approaches to various procedures.” – Dermatologic Surgeon.
- “Its safety profile is excellent when used correctly. Understanding maximum dosing and the signs of LAST is critical for every clinician who uses it.” – Anesthesiologist.
- “The backbone of outpatient dental procedures. Patient acceptance is high due to its rapid efficacy.” – General Dentist.