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The most common combination of agents used in tumescent anesthesia is lidocaine (0.05-0.10%) and epinephrine (1 ppm). [3] [4] [5] For lidocaine, total doses of 35 mg/kg [6] and 55 mg/kg [7] have been reported as reasonably safe high-end doses, in the context of liposuction.
The epinephrine causes vasoconstriction which in turn reduces systemic distribution of the anesthetic as well as prolongs its action in addition to decreasing bleeding at the operating site. Lidocaine 2% with 1:100,000 adrenaline is the local anesthetic of choice in the treatment of pregnant women. [28]
Aside from its use as a dental anesthetic, procaine is used less frequently today, since more effective (and hypoallergenic) alternatives such as lidocaine (Xylocaine) exist. Like other local anesthetics (such as mepivacaine, and prilocaine), procaine is a vasodilator, thus is often coadministered with epinephrine for the purpose of ...
When epinephrine is mixed with local anesthetics, such as bupivacaine or lidocaine, and used for local anesthesia or intrathecal injection, it prolongs the numbing effect and motor block effect of the anesthetic by up to an hour. [45] Epinephrine is frequently combined with local anesthetic and can cause panic attacks. [46]
Class of medications that are competitive antagonists that block the receptor sites for the endogenous catecholamines epinephrine (adrenaline) and norepinephrine (noradrenaline) on adrenergic beta receptors, of the sympathetic nervous system.
Like lidocaine, bupivacaine is an amino-amide anesthetic; the aromatic head and the hydrocarbon chain are linked by an amide bond rather than an ester as in earlier local anesthetics. As a result, the amino-amide anesthetics are more stable and less likely to cause allergic reactions.
Articadent with epinephrine 1:200,000; Orabloc (articaine hydrochloride 4% and epinephrine 1:200,000) An epinephrine-free (adrenaline-free) version is available in Europe under the brand name Ultracain D. However, version with epinephrine (adrenaline) is available in Europe under the brand name Supracain 4% with epinephrine concentration of 1: ...
[4] [12] [14] [17] [27] Therapeutic alternatives with similar clinical performance are listed for some medicines and they may be considered for national essential medicines lists. [17] [18] The 9th Essential Medicines List for Children was updated in July 2023. [23] [28] Note: An α indicates a medicine is on the complementary list. [4] [14] [17]
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