Lidocaïne Aguettant (Lidocaine Hydrochloride)

• Lidocaine is used to produce local anesthesia by blocking nerve conduction in various procedural contexts.
• Minor surgical or diagnostic procedures: provides localized numbness to allow painless incision, biopsy or minor surgery.
• Infiltration anesthesia: delivers anesthetic effect in tissue planes for dental, dermatologic or orthopedic interventions.
• Intravenous regional anesthesia (Bier block): creates a reversible nerve block of an extremity for short‑duration surgeries.
• Intracutaneous testing: used for skin testing and allergy assessments.

• Lidocaine exerts its effect by reversibly binding to the intracellular portion of voltage‑gated sodium channels in neuronal membranes. This blockade prevents the rapid influx of sodium ions during depolarization, thereby inhibiting the initiation and propagation of action potentials. The result is a temporary loss of sensory and, at higher concentrations, motor nerve conduction in the targeted area. The effect is concentration‑dependent and reversible once the drug diffuses away.

Lidocaine may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Transient burning or stinging at injection site
• Tingling or numbness extending beyond target area
• Mild dizziness or light‑headedness
• Nausea or vomiting
• Mild hypotension
• Local swelling or erythema

Serious or Rare Side Effects

• Seizures or convulsions due to systemic toxicity
• Cardiac arrhythmias including ventricular tachycardia
• Methemoglobinemia leading to cyanosis
• Severe allergic reactions such as anaphylaxis
• Respiratory depression or apnea
• Persistent neurologic deficits

When using Lidocaine, clinicians should observe several precautionary measures to minimise risk.

• Allergy assessment: confirm no known hypersensitivity to amide‑type local anesthetics
• Cardiovascular monitoring: observe heart rate and blood pressure during high‑dose or rapid administration
• Hepatic function: adjust dose in patients with severe liver impairment
• Concurrent CNS depressants: use caution with benzodiazepines, opioids or alcohol
• Pregnancy and lactation: safety category unknown; weigh benefits against potential risks
• Store at ambient temperature: keep in original container, protect from moisture and light

Lidocaine can interact with other medicines, altering its plasma concentration or enhancing adverse effects.

Major Interactions (Avoid)

• Class I antiarrhythmics (e.g., quinidine, procainamide): may cause additive cardiotoxicity
• CYP3A4 inhibitors (e.g., amiodarone, ketoconazole): increase lidocaine levels and risk of toxicity
• Other local anesthetics: concurrent use can precipitate systemic toxicity
• Central nervous system depressants (e.g., benzodiazepines, opioids): enhance sedation and respiratory depression

Moderate Interactions (Monitor Closely)

• CYP1A2 inducers (e.g., carbamazepine, phenobarbital): may reduce lidocaine efficacy
• Diuretics (e.g., furosemide): may lower plasma protein binding, increasing free drug
• Beta‑blockers: may potentiate bradycardia when combined with lidocaine