Lidocaine (Lidocaine Hydrochloride) - Summary

LIDOCAINE SUMMARY

LIDOCAINE
HYDROCHLORIDE
INJECTION, USP

Lidocaine HCI Injection, USP is a sterile aqueous solution that contains a local anesthetic agent and is administered parenterally. See INDICATIONS for specific uses.

Lidocaine HCI Injection, USP with preservatives is indicated for production of local or regional anesthesia, by infiltration techniques such as percutaneous injection and by peripheral nerve block techniques such as brachial plexus and intercostal, when the accepted procedures for these techniques as described in standard textbooks are observed.

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NEWS HIGHLIGHTS

Published Studies Related to Lidocaine

The analgesic effect of paracetamol when added to lidocaine for intravenous regional anesthesia. [2009.10]
BACKGROUND: In this study, we evaluated the effect of paracetamol on sensory and motor block onset time, tourniquet pain, and postoperative analgesia, when added to lidocaine in IV regional anesthesia (IVRA)... CONCLUSION: The addition of paracetamol during IVRA with lidocaine decreased tourniquet pain, increased anesthesia quality, and decreased postoperative analgesic consumption.

Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. [2009.09.01]
BACKGROUND: The aim of this trial was to assess the relative efficacy of a sage/echinacea spray and a chlorhexidine/lidocaine spray in the treatment of acute sore throats... CONCLUSION: An echinacea/sage preparation is as efficacious and well tolerated as a chlorhexidine/lidocaine spray in the treatment of acute sore throats.

The impact of topical lidocaine on pain level assessment during and after vacuum-assisted closure dressing changes: a double-blind, prospective, randomized study. [2009.09]
BACKGROUND: Vacuum-assisted closure dressing changes are frequently painful. The authors hypothesized that administering topical lidocaine into the vacuum-assisted closure sponge would decrease pain during dressing changes... CONCLUSIONS: During the initial vacuum-assisted closure dressing change, 0.2% lidocaine administered through the suction tubing led to a reduction in pain reported by the patients in the authors' study. The duration of lidocaine administered in this fashion may be fairly short, because more patients in this group began to request small doses of opiates 30 minutes after the dressing change. Thus, lidocaine may improve patient comfort during vacuum-assisted closure therapy.

Lidocaine jelly and plain aqueous gel for urethral straight catheterization and the Q-tip test: a randomized controlled trial. [2009.09]
OBJECTIVE: To compare the pain perception between lidocaine and plain aqueous gel during assessment of postvoid residual volume and the Q-tip test... CONCLUSION: When compared with plain aqueous gel, 2% lidocaine jelly significantly reduces pain perception during evaluation of postvoid residual volume and the Q-tip test. LEVEL OF EVIDENCE: I.

Standard versus pH-adjusted and lidocaine supplemented radiocolloid for patients undergoing sentinel-lymph-node mapping and biopsy for early breast cancer (PASSION-P trial): a double-blind, randomised controlled trial. [2009.09]
BACKGROUND: Sentinel-lymph-node (SLN) mapping and biopsy maintains staging accuracy in early breast cancer and identifies patients for selective lymphadenectomy. SLN mapping requires injection of technetium-99m-sulfur colloid-an effective but sometimes painful method, for which better pain-management strategies are needed. In this randomised, double-blind trial, we compared degree of pain between standard radiocolloid injection and pH-adjusted and lidocaine-supplemented formulations for patients undergoing SLN mapping for breast cancer... INTERPRETATION: For centres that use radiocolloid injections for SLN mapping in patients with early breast cancer, the addition of 1% lidocaine to the radioisotope solution can improve patient comfort, without compromising SLN identification. FUNDING: US Military Cancer Institute, the Clinical Breast Care Project, and the Army Regional Anesthesia and Pain Management Initiative.

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Clinical Trials Related to Lidocaine

Comparison of the Total Dose and Efficacy of Two Lidocaine Concentrations Needed for Cutaneous Surgery Local Anesthesia [Completed]
The purpose of the study will be to demonstrate whether Mohs micrographic surgery can be performed with a lower total dose of local anesthesia (and greater patient safety) when using 0. 5% lidocaine with 1: 200,000 epinephrine versus 1% lidocaine with 1: 100,000 epinephrine.

Preemptive Analgesia for Postlaminectomy [Completed]
To relieve post laminectomy pain, we have tried intraoperative perineural injection of lidocaine right after the exposure in expecting that this would be preemptive analgesia by blocking the nerve transmission so that postoperative pain starts later and lighter.

Lidocaine Lubricant in Pediatric Urethral Catheterization [Completed]
In Emergency Departments (ED) across the nation there is renewed interest in finding ways to alleviate the pain and discomfort associated with many of the procedures that children must undergo. In a policy by the American Academy of Pediatrics, a nationally recognized advocate for children, physicians are urged to advocate for child-specific research in pain management and the effective use of pain medication to ensure compassionate and competent management of pain. (AAP Statement, 2001) Pediatric urethral catheterizations are one such procedure in which children experience significant pain.(11) In present care, children over 2 months of age do not routinely receive intervention for urethral catheterization related anxiety and pain, and, anecdotal reports suggest that most require physical restraint to complete the procedure. Lidocaine is an anesthetic agent that provides relief from pain during many commonly performed ED procedures. Intraurethral Lidocaine has been shown to decrease pain associated with urethral catheter placement in cystograms, however, Lidocaine is not routinely used for urethral catheterizations in the CHOA ED.

This study aims to investigate the potential use of Lidocaine as an anesthetic agent during urethral catheterization of children. Recently, two specific studies were performed investigating the use of Lidocaine to decrease discomfort associated with urethral catheterization. Using the strengths of both previously published studies, our study will use Lidocaine both topically and instilled into the urethra. Investigators plan to perform a prospective three-arm double-blinded randomized clinical trial investigating the effectiveness of Lidocaine jelly as a analgesic when used as a lubricant for urinary catheterization. Investigators aim to demonstrate that Lidocaine used as a lubricant anesthetic for urethral catheterization will provide a safe, time-efficient, and relatively easy way to decrease pediatric pain in the emergency department setting.

Efficacy and Safety Study of Lidocaine Vaginal Gel for Recurrent Dysmenorrhea (Painful Periods) [Active, not recruiting]
The purpose of this study is to determine whether lidocaine vaginal gel is safe and effective for preventing or reducing the severity of dysmenorrhea (painful menstrual periods) compared to placebo (inactive gel).

Lidocaine Supplement for Minimal Invasive Parathyroid Surgery [Completed]
Primary Objective:

1. To determine if the application of lidocaine to the airway will obtund or abolish the laryngeal reflexes. This in turn will lead to a quiescent controlled surgical field.

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PATIENT REVIEWS / RATINGS / COMMENTS

Lidocaine review by 64 year old female patient
		Rating
Overall rating:
Effectiveness:		Highly Effective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		nerve and muscle pain
Dosage & duration:		5% (700 mg - 50 mg per gram adhesive) taken 1 for up to 12 hours@ 24 hours as needed for the period of Sporatically, as needed
Other conditions:		fibromyalgia
Other drugs taken:		naproxen sodium
		Reported Results
Benefits:		Almost immediate (i.e. within 15 minutes) relieve of severe nerve and/or muscle pain in neck, shoulder &/or lower back. These patches work like a miracle for me, although others who have used them say they offered no relief for muscle or nerve or shingles pain. I have bone spurs in my neck which sometimes irritate the nerves in my neck and cause excrutiating pain ... also periodic sciatica and shoulder and upper & lower pack pain from an auto accident. Chiropractic and message helps, but these patches are used when those interventions fail to bring about sufficient relief ... especially for the nerve pain in my neck. I use them only as a last resort.
Side effects:		Relief of pain! No bad side effects.
Comments:		Although the packaging indicates that up to 3 Lidoderm patches can be used at one time for up to 12 hours in a 24 hour period, I have never used more then two patches, and then only rarely. I usually use one patch and cut it into several pieces to fit specific areas. I have used one patch, cut into 2 pieces on my neck for up to 24 hours several times (i.e. replaced the first patch with a second at the end of a 12 hour period) during severe pain episodes, without any harmful side effects.