Lidocaína B. Braun (Lidocaine Hydrochloride)

• Lidocaine is employed as a local anesthetic for procedures involving peripheral and central nervous system pathways.
• Minor surgical procedures: provides surface anesthesia for incision and tissue manipulation
• Epidural analgesia: delivers analgesia for labor, postoperative pain, or chronic pain management
• Intravenous regional anesthesia (Bier block): enables temporary limb anesthesia for short procedures
• Intradermal skin testing: facilitates local anesthesia for allergy testing

• Lidocaine exerts its effect by reversibly binding to the intracellular portion of voltage‑gated sodium channels in neuronal membranes. This blockade stabilizes the neuronal membrane, preventing the rapid influx of sodium ions required for depolarization, and thus inhibits the initiation and propagation of nerve impulses that convey pain signals.

Adverse reactions may occur following administration of lidocaine.

Common Side Effects

• Transient burning or stinging at the injection site
• Tingling or numbness in the treated area
• Mild hypotension or dizziness
• Nausea or mild headache
• Localized swelling or erythema
• Temporary muscle weakness

Serious or Rare Side Effects

• Systemic toxicity presenting as seizures, CNS depression, or cardiac arrhythmias
• Severe allergic reactions including urticaria, angioedema, or anaphylaxis
• Methemoglobinemia, a rare disorder affecting oxygen transport
• Persistent numbness or paresthesia beyond the expected duration
• Cardiac arrest in cases of high plasma concentrations
• Respiratory depression in severe toxicity

• When using lidocaine, clinicians should observe several safety measures.
• Assess patient allergy: verify no known hypersensitivity to amide‑type local anesthetics
• Monitor cardiovascular status: observe blood pressure and heart rate during administration
• Limit total dose: adhere to recommended maximum cumulative dose for the selected route
• Avoid intravascular injection: aspirate before injection to confirm extravascular placement
• Use with caution in hepatic impairment: consider dose adjustment or alternative agents
• Store at controlled room temperature: keep in original container, protect from light and moisture

Lidocaine may interact with other medicines, requiring attention to potential effects.

Major Interactions (Avoid)

• Class I antiarrhythmics (e.g., quinidine, procainamide): may increase lidocaine plasma levels
• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): can raise systemic exposure

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may enhance hypotensive effect of lidocaine
• General anesthetics (e.g., propofol, sevoflurane): additive central nervous system depression
• Diuretics (e.g., furosemide): may alter plasma protein binding and affect lidocaine concentration