Lidocaïne/Adrenaline Aguettant (Epinephrine, Lidocaine Hydrochloride)

Lidocaïne/Adrenaline is a local anesthetic combination used in procedures requiring regional or infiltration anesthesia.

• Minor surgical procedures: provides rapid onset local anesthesia with prolonged duration due to vasoconstriction.
• Epidural anesthesia: extends the sensory block while limiting systemic absorption.
• Infiltration anesthesia: enhances depth and duration of numbness for tissue infiltration.
• Intravenous regional (Bier) block: reduces systemic toxicity by limiting lidocaine spread.

• Lidocaine blocks voltage‑gated sodium channels in neuronal membranes, preventing the initiation and propagation of action potentials, which produces loss of sensation. Epinephrine activates α‑ and β‑adrenergic receptors, causing vasoconstriction at the injection site, which reduces local blood flow, delays systemic absorption of lidocaine, and thereby prolongs and intensifies the anesthetic effect. The combined effect allows clinicians to use lower concentrations of lidocaine while achieving adequate analgesia.

Adverse reactions to Lidocaïne/Adrenaline may vary in frequency and severity.

Common Side Effects

• Injection site pain or burning sensation.
• Transient tingling or numbness beyond the target area.
• Light‑headedness or dizziness.
• Nausea or mild vomiting.
• Temporary increase in heart rate.

Serious or Rare Side Effects

• Severe hypertension or hypertensive crisis.
• Cardiac arrhythmias, including ventricular tachycardia.
• Allergic reactions such as urticaria, angioedema, or anaphylaxis.
• Methemoglobinemia.
• Central nervous system toxicity manifesting as seizures or loss of consciousness.

Before using Lidocaïne/Adrenaline, clinicians should consider several safety precautions.

• Cardiovascular assessment: evaluate blood pressure and heart rhythm due to epinephrine’s sympathomimetic effects.
• Use caution in patients with uncontrolled hypertension or coronary artery disease.
• Avoid in individuals with known hypersensitivity to lidocaine, epinephrine, or any excipients.
• Monitor for signs of systemic toxicity, especially when large volumes are administered.
• Adjust dosage in pediatric or geriatric patients as recommended by the prescriber.
• Store at room temperature: keep in the original container, protect from moisture and light.

Lidocaïne/Adrenaline can interact with other medicines, influencing its efficacy or safety.

Major Interactions (Avoid)

• Non‑selective β‑blockers (e.g., propranolol): may potentiate epinephrine‑induced hypertension and bradycardia.
• Monoamine oxidase inhibitors (MAOIs): increase risk of hypertensive crisis when combined with epinephrine.
• Tricyclic antidepressants: can enhance lidocaine’s cardiotoxic potential.
• Class I antiarrhythmic agents (e.g., quinidine): may exacerbate cardiac conduction disturbances.

Moderate Interactions (Monitor Closely)

• Other local anesthetics: cumulative toxicity risk if used concurrently.
• Vasoconstrictors (e.g., phenylephrine): may augment local vasoconstriction and systemic blood pressure.
• Sympathomimetic drugs (e.g., dopamine): additive cardiovascular effects.
• Calcium channel blockers: may alter vascular response to epinephrine.