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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Local Anesthetic Properties for Lidocaine


- See: systemic lidocaine administration

- Discussion:
    - maximum dose: 4.5mg/kg or 300mg (28 ml of 1% solution) or 50 mL of 1% solution w/ added Epinephrine (1:200,000);
    - duration of action:
           - anesthetic onset in 5-30 min, lasting 2-3 hr;
           - addition of sodium bicarbonate (8.4%, 10 meq/L) to 1% lidocaine may reduce the burning experienced from injection (most likely caused by acidity);
           - add 1-2 ml of bicarbonate for each 10 ml of 1% lidocaine used;
    - addition of epinephrine:
           - epinephrine added to injectable forms for anesthesia to prolong effects & help decrease bleeding;
           - must not be used on digits, penis, or ears and careful w/ HTN;
           - dose: 50 mL of 1% solution w/ added epinephrine (1:200,000);
    - precautions:
           - w/ IV forms, dosage reduction is required with liver disease, CHF;
           - toxicity: dizziness, confusion, slurred speech, paresthesias, convulsions associated with toxicity: > 6-8ug / ml=toxic



Serum lidocaine levels during arthroscopy using continuous irrigation with lidocaine.

Intravenous lidocaine for anesthesia in the lower extremity. A prospective study.

Anesthetic properties and toxicity of bupivacaine and lidocaine for infiltration anesthesia.

Damage to tissue defenses by a topical anesthetic agent.

A clinical comparison of lidocaine and bupivacaine.

Reducing the pain associated with local anaesthetic infiltration for open carpal tunnel decompression.

Lidocaine Exhibits Dose- and Time-Dependent Cytotoxic Effects on Bovine Articular Chondrocytes In Vitro

Human Chondrocyte Viability After Treatment With Local Anesthetic and/or Magnesium: Results From an In Vitro Study



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, December 16, 2011 3:42 pm