1. Introduction
DOLOCAINE is a local anesthetic preparation containing Lidocaine Hydrochloride, available in multiple formulations for versatile medical use. It provides rapid, effective local anesthesia for various clinical procedures.
2. Description
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Generic Name:Â Lidocaine HCl
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Available Formulations:
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Injection (1%, 2%)
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Topical jelly (2%)
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Cream (5%)
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Spray (10%)
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Drug Class:Â Amide-type local anesthetic
3. Uses
✔ Local anesthesia for minor surgical procedures
✔ Dental anesthesia (infiltration/nerve block)
✔ Cardiac arrhythmias (IV form)
✔ Topical anesthesia for mucous membranes
✔ Post-herpetic neuralgia (patch formulation)
4. Mechanism of Action
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Blocks voltage-gated sodium channels
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Inhibits depolarization of nerve fibers
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Onset:Â 2-5 minutes (injection), 3-5 minutes (topical)
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Duration:Â 30-120 minutes (varies by formulation)
5. Side Effects
Common:
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Injection site reactions (pain, swelling)
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Temporary numbness beyond target area
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Mild dizziness (systemic absorption)
Serious (Require Immediate Attention):
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CNS toxicity (tinnitus, seizures)
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Cardiovascular depression
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Allergic reactions (rare with amides)
6. Storage
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Injection: Room temperature (15-30°C)
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Topicals: Below 25°C
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Protect from light
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Do not freeze
7. Precautions & Warnings
âš Â Contraindications:
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Hypersensitivity to amide anesthetics
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Severe heart block (for IV use)
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Porphyria
âš Â Special Populations:
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Elderly: Reduced dose needed
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Hepatic impairment: Caution with repeated doses
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Pregnancy: Category B (use if benefits outweigh risks)
âš Â Maximum Recommended Doses:
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Plain: 4.5 mg/kg (max 300 mg)
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With epinephrine: 7 mg/kg (max 500 mg)
8. Comparison of Formulations
Formulation | Concentration | Onset | Duration | Max Dose |
---|---|---|---|---|
Injection | 1-2% | 2-5 min | 30-90 min | 4.5 mg/kg |
Jelly | 2% | 3-5 min | 15-30 min | 3 mg/kg |
Spray | 10% | 1-2 min | 10-15 min | 3 sprays |
9. Clinical Pearls
• Test dose recommended for nerve blocks
• Aspirate before injection to avoid IV administration
• Add epinephrine (1:200,000) to prolong duration when appropriate
• Monitor for CNS symptoms during large dose administration
10. Conclusion
DOLOCAINE remains the gold standard local anesthetic due to its:
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Rapid onset
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Predictable duration
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Excellent safety profile
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Multiple formulation options
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