Lidocaine hydrochloride/epinephrine

LIDOCAINE HYDROCHLORIDE/EPINEPHRINE (Xylocaine with epinephrine injection 0.5%)... 

Lidocaine hydrochloride [73-78-9] (Xylocaine), is the most versatile local anesthetic agent because of its moderate potency and duration of action, rapid onset, topical activity, and low toxicity. Its main indications are for infiltration, peripheral nerve blocks, extradural anesthesia, and in spinal anesthesia where a duration of 30 to 60 min is desirable. Because of its vasodilator activity, addition of the vasoconstrictor, epinephrine, increases the duration of action of Hdocaine markedly. It is also available in ointment or aerosol preparations for a variety of topical appHcations. 

S. M. Waraszkiewicz, E. A. Milano, and R. L. DiRubio, A stability indicating LCEC method for epinephrine and its application to the analysis of lidocaine hydrochloride injectable solutions, Curr. Sep., 4(2) 23 (1982). 

Lidocaine hydrochloride is a local anesthetic/vasopressor preparation. Lidocaine stabilizes neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anesthetic action. Epinephrine stimulates both alpha and beta receptors within sympathetic nervous system relaxes smooth muscle of bronchi and iris and is an antagonist of histamine. They are indicated for production of local or regional anesthesia by infiltration techniques such as percutaneous injection, by peripheral nerve block techniques such as brachial plexus and intercostals, and by central neural techniques such as lumbar and caudal epidural blocks. 

Wilson, T.D. Forde, M.D. Stability of milrinone and epinephrine, atropine sulfate, lidocaine hydrochloride, or morphine sulfate injection. Am.J.Hosp.Pharm., 1990, 47, 2504-2507... 

Mepivacaine hydrochloride (Carbocaine) is longer acting than lidocaine and has a more rapid onset of action (3-5 minutes). Topical application is not effective. It has been widely used in obstetrics, but its use has declined recently because of the early transient neurobehavioral effects it produces. Adverse reactions associated with mepivacaine are generally similar to those produced by other local anesthetics. It can be used with epinephrine or levonordefrin (dental use only). 

The selectivity of amperometric detection has been useful in simplifying the sample pretreatment steps in the determination of a number of drug products [82-86]. A method requiring no sample preparation using an amperometric detector and UV detector in series was developed for lido-caine hydrochloride injectable solutions [87]. The drug epinephrine is quantified with the amperometric detector, whereas lidocaine and methyl para-ben are detected by ultraviolet light. Disodium EDTA had to be added to the mobile phase to eliminate a peak response from iron leached from the stainless steel. 

Larson, T.A. and Schilling, C.G. (1996) Stability of epinephrine hydrochloride in an extemporaneously compounded topical anaesthetic solution of lidocaine, racepinephrine and tetracaine, Am. J. Health-Syst. Pharm., 53, 659-662. 

Mepivacaine hydrochloride [N-(2, 6-dimethylphenyl)-1-methyl 2-piperidinecarboxamide monohydrochloride] is an amino amide-type local anesthetic agent widely used to provide regional analgesia and anesthesia by local infiltration, peripheral nerve block, and epidural and caudal blocks. The pharmacological and toxicological profile of mepivacaine is quite similar to that of lidocaine, except that mepivacaine has a slightly longer duration of action and lacks the vasodilator activity of lidocaine. For this reason, it serves as an alternate choice for lidocaine when addition of epinephrine is not recommended in patients with hypertensive vascular disease. 

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