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Lidocaine

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

By injection

Causes numbness or loss of feeling in an area of your body. Given before and during surgery, childbirth, or dental work. Also treats emergency heart rhythm… Read more

Brand names include: Accucaine, Active Injection Kit BLM-1

Into the eye

Lidocaine belongs to the family of medicines called local anesthetics. This medicine is applied in the eye to cause numbness or loss of feeling before… Read more

Brand names include: Akten

Into the skin

Lidocaine injection is used to numb the skin before certain painful procedures such as drawing blood or inserting an intravenous line. Lidocaine belongs… Read more

Brand names include: Zingo

On the skin

Numbs the skin and relieves pain caused by shingles or other conditions. This medicine is a topical anesthetic… Read more

Brand names include: Anastia, Anecream

On the skin

Treats nerve pain that is caused by herpes zoster or shingles… Read more

Brand names include: Aspercreme, DermacinRx PHN Pak

Into the mouth

Relieves pain… Read more

Brand names include: Advanced DNA Medicated Collection Kit, Advanced DNA Medicated Collection Kit II

Drug classes About this
Anesthetic, Local, Antiarrhythmic, Group IB
Combinations including this drug

What works? Research summarized

Evidence reviews

Temporary pain in the lower extremities following spinal anaesthesia with lidocaine compared to other local anaesthetics

Lidocaine is the drug of choice for inducing spinal anaesthesia in ambulatory surgery because of its rapid onset of action, intense nerve blockade, and short duration of action. The possible side effects of spinal anaesthesia in adults, which develop after recovery, are backache, post‐dural puncture headache, and transient neurologic symptoms that are characterized by slight to severe pain in the buttocks and legs. TNS symptoms develop within a few hours and up to 24 hours after anaesthesia. They last, in most cases, up to two days. The present review shows that lidocaine is more likely to cause transient neurologic symptoms than bupivacaine, prilocaine, and procaine. However, these drugs produce prolonged local anaesthetic effects and therefore are not desirable for ambulatory patients. It is possible that the reintroduction of 2‐chloroprocaine will solve this lack of a suitable intrathecal local anaesthetic; confirmatory studies are needed.

Lidocaine for pain relief in people with burns

Burns are very common and sometimes fatal, and the pain associated with such injury is one of the most difficult types to relieve. The use of high‐dose opioid medications like morphine is common, but side effects are encountered. Alternative agents such as lidocaine, an anaesthetic, have been proposed. This is an update of the review of the same name first published in 2007.

Injection of lignocaine into a dislocated shoulder joint versus injection of a pain‐relieving drug with or without injection of a sedative drug into a vein for the purpose of manual manipulation of acute (less than 48 hours old) anterior (towards the front) displacement of a shoulder joint from its normal position.

Joint dislocation refers to displacement of the bones which form a joint away from their anatomical position. The shoulder is the most commonly dislocated joint managed in the emergency department (ED). When the dislocation occurs towards the front of the body, this is known as an anterior shoulder dislocation. It is called an acute anterior shoulder dislocation if the dislocation occurred with the previous 48 hours. Manually manipulating the displaced bones back to their normal position (manual reduction) is very painful. To allow for manual reduction, pain relief can be achieved either by injecting a local anaesthetic drug (for example, lignocaine) into the dislocated shoulder joint (intra‐articular lignocaine injection); or by injecting a pain killer with or without a sedative directly into the bloodstream through a vein (intravenous analgesia). The review authors searched the medical literature and identified five studies comparing these two methods. The studies included 211 patients with acute anterior shoulder dislocation; 113 patients underwent intra‐articular lignocaine injection and 98 underwent intravenous analgesia with sedation. The review found that there may be no difference in the immediate success of manual reduction of the dislocated shoulder between patients receiving intra‐articular lignocaine injection and those who received intravenous analgesia and sedation. However, intra‐articular lignocaine injection may be associated with fewer side effects and a shorter stay in the emergency department before discharge from hospital. Compared with intravenous analgesia and sedation, intra‐articular lignocaine may also be cheaper. However, the relatively small number of studies included in the review and the relatively small number of patients in each study means that the results of the review preclude definitive conclusions regarding the superiority of either method..

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Summaries for consumers

Temporary pain in the lower extremities following spinal anaesthesia with lidocaine compared to other local anaesthetics

Lidocaine is the drug of choice for inducing spinal anaesthesia in ambulatory surgery because of its rapid onset of action, intense nerve blockade, and short duration of action. The possible side effects of spinal anaesthesia in adults, which develop after recovery, are backache, post‐dural puncture headache, and transient neurologic symptoms that are characterized by slight to severe pain in the buttocks and legs. TNS symptoms develop within a few hours and up to 24 hours after anaesthesia. They last, in most cases, up to two days. The present review shows that lidocaine is more likely to cause transient neurologic symptoms than bupivacaine, prilocaine, and procaine. However, these drugs produce prolonged local anaesthetic effects and therefore are not desirable for ambulatory patients. It is possible that the reintroduction of 2‐chloroprocaine will solve this lack of a suitable intrathecal local anaesthetic; confirmatory studies are needed.

Lidocaine for pain relief in people with burns

Burns are very common and sometimes fatal, and the pain associated with such injury is one of the most difficult types to relieve. The use of high‐dose opioid medications like morphine is common, but side effects are encountered. Alternative agents such as lidocaine, an anaesthetic, have been proposed. This is an update of the review of the same name first published in 2007.

Injection of lignocaine into a dislocated shoulder joint versus injection of a pain‐relieving drug with or without injection of a sedative drug into a vein for the purpose of manual manipulation of acute (less than 48 hours old) anterior (towards the front) displacement of a shoulder joint from its normal position.

Joint dislocation refers to displacement of the bones which form a joint away from their anatomical position. The shoulder is the most commonly dislocated joint managed in the emergency department (ED). When the dislocation occurs towards the front of the body, this is known as an anterior shoulder dislocation. It is called an acute anterior shoulder dislocation if the dislocation occurred with the previous 48 hours. Manually manipulating the displaced bones back to their normal position (manual reduction) is very painful. To allow for manual reduction, pain relief can be achieved either by injecting a local anaesthetic drug (for example, lignocaine) into the dislocated shoulder joint (intra‐articular lignocaine injection); or by injecting a pain killer with or without a sedative directly into the bloodstream through a vein (intravenous analgesia). The review authors searched the medical literature and identified five studies comparing these two methods. The studies included 211 patients with acute anterior shoulder dislocation; 113 patients underwent intra‐articular lignocaine injection and 98 underwent intravenous analgesia with sedation. The review found that there may be no difference in the immediate success of manual reduction of the dislocated shoulder between patients receiving intra‐articular lignocaine injection and those who received intravenous analgesia and sedation. However, intra‐articular lignocaine injection may be associated with fewer side effects and a shorter stay in the emergency department before discharge from hospital. Compared with intravenous analgesia and sedation, intra‐articular lignocaine may also be cheaper. However, the relatively small number of studies included in the review and the relatively small number of patients in each study means that the results of the review preclude definitive conclusions regarding the superiority of either method..

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