“Lidocaine” – all about the properties, effectiveness and application features

It is difficult to imagine modern medicine without drugs for pain relief, because every day, many people turn to doctors for treatment, and some cases require surgical or other painful procedures.

In such cases, anesthetics come to the aid of doctors and the patient, which temporarily block the flow of nerve impulses along the nerve endings, eliminating pain and facilitating treatment. Among the many drugs, the most accessible and widely used are Lidocaine and Novocaine.

Lidocaine is a powerful topical anesthetic widely used in many areas of medical practice. It has a more pronounced effect than Novocaine or Cocaine, and is used exclusively topically. Lidocaine is highly toxic, so it is used with extreme caution. Lidocaine is completely contraindicated for children under 10 years of age.

Novocaine is a kind of medicine that has a moderate anesthetic effect. Its scope of application is not limited primarily to local anesthesia, despite its short period of action. Novocaine is completely synthetic, and when absorbed into the bloodstream, it is capable of providing anti-inflammatory, analgesic, antiallergic and desensitizing effects. In addition, it relaxes smooth muscles and reduces the excitability of the heart.

"Lidocaine" - what kind of drug is it?

According to its chemical characteristics, this drug belongs to the amide group - it has a deep analgesic effect. However, today this anesthetic is considered to be of average effectiveness, therefore, along with the even less powerful Novocaine, it is used mainly in municipal dental clinics. By the way, procaine-based anesthesia has practically no effect when working with inflamed tissues in the presence of purulent processes.

"Lidocaine" is a local anesthetic drug

Lidocaine hydrochloride blocks nerve conduction, causing the treated area to be completely numb. However, today this drug belongs to the anesthetic of the past. It has been replaced by more effective analogues with deep and long-lasting action. This category includes medications based on articaine - “Ultracaine”, “Septanest”, “Ubistezin” and others.

Comparison of Lidocaine and Novocaine

Lidocaine and Novocaine are the most popular anesthetics that are used not only in medical institutions, but also outside them.
Despite the fact that they are used primarily as painkillers, these drugs differ from each other both in composition and in the nature of their effects.

These differences and features allow the drugs to be used in different situations and with varying effectiveness.

Compound similarities

Regardless of the form of release, the drug Lidocaine contains an active substance - lidocaine hydrochloride. The injection ampoules contain sodium chloride and water as additional ingredients.

Lidocaine and Novocaine are the most popular anesthetics that are used not only in medical institutions, but also outside them.

The composition of the spray, in addition to lidocaine, includes:

alcohol (ethanol);
peppermint oil;
propylene glycol.

There is also an ointment under the same name. It is intended for local anesthetic use. The composition of the drug, in addition to the active substance, includes:

chlorhexidine dihydrochloride;
water;
glycerol;
hyaetellosis.

The drug Novocaine contains procaine hydrochloride as the main active substance. Such drugs with an analgesic effect are available in the form of:

solution for injections;
solution for infusion;
rectal suppositories (pain relief for hemorrhoids).

In addition to procaine hydrochloride, such preparations contain only excipients necessary to give the medicine the desired form.

Thus, Novocaine and Lidocaine do not contain substances that allow us to draw a conclusion about their chemical identity. However, the similarity is observed in the fact that these drugs have the same property - a strong analgesic effect.

In addition, solutions of both substances are used to dilute medications produced in the form of dry powders. For example, it is recommended to dilute Ceftriaxone with Lidocaine (1%).

In this case, the patient not only receives the required dose of antibiotic, but also the procedure is painless. Ceftriaxone and other antibiotics can be diluted with Novocaine, but Lidocaine is a better pain reliever.

However, Novocaine has fewer side effects, which influences the choice of solvent.

It is recommended to dilute Ceftriaxone with Lidocaine (1%). In this case, the patient not only receives the required dose of antibiotic, but also the procedure is painless.

What is the difference

The difference between these drugs is not only in the chemical composition. Despite the fact that both drugs have analgesic properties, they act differently.

If we compare drugs in terms of effectiveness, we can come to the conclusion that Lidocaine differs from Novocaine primarily in the strength of its effect. The effect of Novocaine is weaker. The differences also lie in the duration of the effect (Novocaine does not act as long as Lidocaine).

In addition, Novocaine often causes allergies. Due to toxic effects, it should not be used by pregnant and lactating women.

Lidocaine is prescribed not only for pain relief. It is used as a means of combating arrhythmia, since the administration of the drug increases the permeability of cells to potassium. This blocks the penetration of sodium. Due to this effect on the heart muscle, the drug is used for myocardial infarction and during heart surgery.

Thus, the differences between these drugs come down to the specifics of their analgesic effect and the characteristics of lidocaine’s effect on the heart.

Which is better Lidocaine or Novocaine

In order to understand which is better – Lidocaine or Novocaine, it is necessary to assess the situation and the patient’s condition. Many doctors and patients consider procaine hydrochloride a remedy of yesterday. It was replaced by drugs with a strong and long-lasting effect. These include not only Lidocaine, but also Ultracaine. The latter is already a common means of anesthesia during dental treatment.

Despite the emergence of drugs with a strong analgesic effect, Novocain is widely used in situations that do not require fast, long-term and highly effective pain relief.

Which is stronger

If there is a need for a strong painkiller, then Lidocaine should be chosen. It acts earlier, longer and stronger. However, in some cases, such a choice may not be advisable, since strong painkillers can not only benefit the body, but also cause harm.

Novocaine is widely used in situations that do not require fast, long-term and highly effective pain relief.

Can I take it at the same time?

By simultaneous use we mean the following situations:

mixing both drugs in one syringe and injecting the solution into the blood;
using one product for injection and another in the form of, for example, an ointment or spray;
using different medications in the same way, but after a certain time interval.

Mixing lidocaine and procaine hydrochloride in one solution is strictly prohibited. In this state, substances become not only anesthetics. They have a strong effect on the central nervous system, causing hallucinations. A person’s condition after such an injection can be compared to severe drug poisoning.

All other methods of sharing do not entail such severe consequences. The least dangerous situation is when one drug is used several hours after another.

Since Novocaine has a short-term effect and is quickly eliminated from the body, it is better to use it first.

If there is a need to simultaneously use one of the drugs for injection and the other as a product applied to the skin, then you should first give an injection, and then after 1-2 hours apply, for example, patches. Just first you need to clarify the composition of the anesthetic components with which the patch is impregnated.

Particular caution should be exercised when using medications for pain relief at home. Even the combined use of Novocaine and Lidocaine in the form of sprays, ointments and patches can lead to unpleasant consequences.

Contraindications for the use of Lidocaine and Novocaine

Any drug can cause allergies, individual intolerances and paradoxical reactions. Painkillers are no exception. An allergic reaction is especially common due to Novocaine. In order to minimize the risk when using these drugs for the first time, you must first do an allergy test.

The list of contraindications for the use of Novocaine is limited only to allergies and paradoxical reactions.

Since Lidocaine has not only an analgesic effect on the body, the list of its contraindications is longer. This drug should not be used for:

renal, liver and heart failure;
atrioventricular block;
bradycardia;
low blood pressure;
hypovolemia;
cardiogenic shock;
transverse heart block;
myasthenia gravis;
glaucoma.

This medication in any form of release should be used with caution by people with poor health, epileptics, children and elderly patients. During pregnancy and lactation, the use of sprays, ointments and patches is allowed.

Side effects from Lidocaine and Novocaine

When using Novocaine, the following consequences are possible:

dizziness;
decrease in pressure;
temporary weakening of vision with the appearance of “spots”;
allergic reactions.

The consequences of the administration of lidocaine are very diverse. This:

changes in mood up to euphoria;
the appearance of anxiety;
dizziness;
headache;
weakness to the point of drowsiness;
disorientation;
noise in ears;
confusion;
convulsions;
various types of paralysis, including respiratory paralysis.

These consequences are short-term. However, in some cases they are life-threatening and therefore require emergency measures.

How to use

The dosage of both drugs should be determined by a specialist. This is especially true for intramuscular administration. If a person has no allergies or contraindications, then external application of drugs with an analgesic effect to the skin or mucous membrane is allowed after the analgesic effect from the previous treatment has ceased.

The maximum permissible daily dose of Novocaine for an adult is 10 mg per 1 kg of weight. When using adrenaline as a means of prolonging the effect, 15 mg per 1 kg is allowed.

The dosage of Lidocaine is selected individually for the patient. This is due to the fact that this drug is used not only as an anesthetic.

A child under 10 years old can only use Novocain.

Conditions for dispensing from pharmacies

Both drugs are considered prescription drugs. However, they are dispensed according to prescriptions that do not require a report from pharmacies. This allows employees to sell products without a doctor’s prescription.

When purchasing these medications yourself, you should be careful, since the dosage and form of use for the patient is determined only by the doctor.

Price

The estimated price for Novocain ranges from 28 to 50 rubles per package containing 10 ampoules. A solution of this drug in 200 ml bottles can cost 800 rubles.

Novocaine patch costs about 120 rubles per unit, rectal suppositories cost about 50 rubles per pack of 10 pieces.

Lidocaine solution in ampoules of 10 pcs. costs from 23 to 30 rubles. A 38 g spray can cost the buyer from 230 to 350 rubles. The price range for patches ranges from 50 to 2800 rubles. On average, 1 patch costs from 50 to 90 rubles.

Reviews

Andrey Vasilievich, 68 years old, Krasnoyarsk

I want to warn you - be careful with Lidocaine. It was prescribed as a means of combating arrhythmia. As a result, my blood pressure dropped so much that I had to take emergency measures. The arrhythmia remained the same.

Alexey, 45 years old, therapist, Irkutsk

If the problem is only to eliminate the pain effect, then it is better to use Novocaine or, if you need a strong remedy, then Ultracaine. Lidocaine acts too unpredictably.

Moreover, it is not always clear what is going on.

It can act on the same person without significant side effects, but after a few years the same drug can cause unpleasant and dangerous consequences in the same person.

Ekaterina Mikhailovna, 60 years old, Stavropol

There is no reason to criticize Lidocaine here. For example, with its help it was possible to avoid arrhythmia and bradycardia. I used to suffer so much from heart failure. Injections of this drug cannot be given frequently, but heart patients and hypertensive patients need to take periodic courses.

Mikhail, 36 years old, Khabarovsk

I want to praise the novocaine patches. I always have them ready. For bruises, sprains and chondrotic pain, I immediately use them. For some time you can forget about the pain.

Source: https://predprin.ru/gemorroj/sravnenie-lidokaina-i-novokaina

pharmachologic effect

The drug in question also has its advantages, for example, low cost. It is often used in public clinics as part of free treatment. In addition, Lidocaine has an antiarrhythmic effect, so it is suitable for patients with cardiac arrhythmias. This is a local remedy that rarely causes allergic reactions. The effectiveness of its use varies from 70 to 95%.

This anesthetic is usually administered together with adrenaline (a vasoconstrictor) in the form of a 1-2% solution. As for how quickly it acts, the maximum concentration of the active substance in the blood is observed within 5-10 minutes after administration. The drug dilates blood vessels and does not irritate tissue, which ensures its uniform distribution and smooth onset of the desired effect.

This is a topical remedy that rarely causes allergic reactions.

Compound similarities

Regardless of the form of release, the drug Lidocaine contains an active substance - lidocaine hydrochloride. The injection ampoules contain sodium chloride and water as additional ingredients.

The composition of the spray, in addition to lidocaine, includes:

alcohol (ethanol);
peppermint oil;
propylene glycol.

There is also an ointment under the same name. It is intended for local anesthetic use. The composition of the drug, in addition to the active substance, includes:

chlorhexidine dihydrochloride;
water;
glycerol;
hyaetellosis.

The drug Novocaine contains procaine hydrochloride as the main active substance. Such drugs with an analgesic effect are available in the form of:

solution for injections;
solution for infusion;
rectal suppositories (pain relief for hemorrhoids).

In addition to procaine hydrochloride, such preparations contain only excipients necessary to give the medicine the desired form.

What forms does it come in and what does it contain?

The anesthetic is available in three main forms. This can be a solution in ampoules or carpules, gel or spray. Each of the listed forms is characterized by its area of application - we will analyze each variety in more detail.

Anesthetic spray

A dosed spray is used in dental practice before injecting an anesthetic into the gums, that is, for preliminary tissue anesthesia. The dose of one spray corresponds to approximately 4.8 mg of active substance. One bottle contains 38 g of lidocaine, which is enough for approximately 650 sprays. The composition also contains excipients, including alcohol and flavoring (mint oil). The action time does not exceed 5-6 minutes, and the anesthetic itself is also used in pediatric dentistry - for small patients up to 2 years old.

The drug can be used in the form of a spray

According to the instructions for use, the spray helps reduce the gag reflex during dental procedures. You can buy it at almost any pharmacy, and for this you do not have to present a prescription from a doctor.

Solution for injection - ampoules or carpules

The standard solution contains 20 mg lidocaine hydrochloride, 6 mg sodium chloride, and water for injection. The drug is available in 2 ml ampoules. For relatively simple manipulations, 4-5 ml of a solution without adrenaline may be sufficient. Answering the question about how many hours anesthesia lasts, it should be noted that Ultracain today does not have the longest lasting effect. Its duration of action varies from 30 to 90 minutes.

“I used to get goosebumps just thinking about the dentist. I was always terribly afraid of dental treatment. Probably, a bad experience in childhood made itself felt. I remember they tore out my baby teeth with gumboil, and it was a nightmare!! Already in adulthood, there were also a couple of precedents. I only calmed down when I saw a good doctor. He first had a detailed conversation with me, explained that now the drugs are more powerful and of higher quality. He said that he would inject lidocaine, but first he would numb the injection site itself. In the end, everything went like clockwork, I didn’t even twitch too much. Now I insist only on lidocaine, although everyone is trying to sell me some more modern anesthesia. Well, I do not! I only have good associations with this drug, now I don’t cheat on it.”
NinoCo., from correspondence on the forum www.32top.ru

The drug is available in ampoules of 2 ml.
But modern anesthetics are practically no longer available in ampoules. Now they are packaged in disposable capsules with a pre-calculated dose of solution. This carpule is inserted into a special carpule syringe, after which the doctor fixes a very thin needle on it. This approach simplifies the task for the specialist and makes the injection completely painless even without prior application of anesthesia. An example of a drug in carpules based on ultracaine is the French product Xylonor.

Epinephrine, adrenaline or norepinephrine, a vasoconstrictor with a vasoconstrictor effect, can be administered as a special additive to prolong the analgesic effect.

The drug is in gel form

Gels based on the active substance are different. There are both for professional use as part of dental treatment, and for independent use. One of these products is the Kamistad gel with analgesic and anti-inflammatory effects. It is often prescribed as part of maintenance therapy in the treatment of gingivitis, stomatitis, irritation and inflammation of the gums of various etiologies, as well as painful teething in childhood and adulthood.

Another analogue is “Cholisal”. It has an even more pronounced analgesic effect and effectively relieves inflammation and swelling. The cost of both drugs varies from 250 to 300 rubles per tube.

Lidocaine dilution: 1% lidocaine from 2%

You have been prescribed a course of antibiotic injections, such as Ceftriaxone. You buy an antibiotic, read the instructions and see: “dilute with 1% lidocaine solution.” You go to the pharmacy, and there it turns out that “there is no such Lidocaine, will you take 2%?”

How to make a 1% solution from a 2% lidocaine solution?

Everything is very simple: Along with the 2% Lidocaine offered to you (in the amount of 1 ampoule per 1 ampoule of Ceftriaxone), also take ampoules of water for injection (1 ampoule per 1 ampoule of 2% Lidocaine). Next, open both ampoules, take half the required dose of lidocaine and the same amount of sterile water, shake the syringe and get the required amount of 1% lidocaine solution.

Example:

To dilute a 1.0 g ampoule of Ceftriaxone, it is recommended to use 3.5 ml of 1% lidocaine as a solvent.
Available 2% solution and ampoule of water for injection. Open both ampoules, take 1.7-1.8 ml of Lidocaine from the ampoule with 2% Lidocaine and 1.7-1.8 ml from the ampoule with water. Shake the syringe and inject the resulting 1% lidocaine solution into the ampoule with Ceftriaxone, having previously treated the ampoule cap with an alcohol solution. / sitemap-index.xml On this site I have collected instructions, reviews and opinions about various medications.

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Instructions for use

As for how much Lidocaine is needed for the treatment and removal of teeth, it should immediately be noted that in this matter much depends on the individual characteristics of the patient’s body, his age, body weight and current state of health. Lidocaine 10% is used for topical anesthesia, and its maximum allowable dosage is 4 ml.

The drug is used for topical anesthesia

"Lidocaine" 0.125%, 0.25%, 0.5% (maximum - 2000 mg) is used as part of infiltration anesthesia, for conduction anesthesia - 1-2% (maximum - 400 mg). This concentration is just right for painless dental treatment and tooth extraction. As mentioned above, in conjunction with this anesthetic, it may be necessary to administer adrenaline (a vasoconstrictor) for a longer and more complex procedure.

Comparative characteristics

Let's move on to consider the similar properties and distinctive qualities of Lidocaine and Novocaine.

Lidocaine and Novocaine have the same property - they have a local analgesic effect, they have a similar chemical structure.

In the manufacture of each of the drugs they use:

a hydrophobic aromatic group;
ester or amide chain;
hydrophilic secondary or tertiary amino group.

Another similar quality of these medications is that a small part of them leaves the body with urine, the rest is destroyed.

What is the difference

The main difference between Lidocaine and Novocaine is that the first medication is an amide, and the second is an ether.

The resulting breakdown products are highly toxic, which can cause a severe allergic reaction.

When compared with esters, amides are characterized by greater stability. After absorption into the blood, they break down more slowly, so the possibility of negative reactions is minimal.

Lidocaine has a more pronounced anesthetic effect compared to Novocaine. For this reason, it is more often prescribed for local use in certain operations and in dentistry.

Novocaine has average analgesic activity. However, the drug is often used by surgeons during short operations.

What hurts more?

Regarding which drug is administered more painfully, it can be argued that it depends on the characteristics of the patient’s body. Although, based on reviews of these medications, it should be said that antibiotics diluted with Lidocaine are administered less painfully in comparison with those diluted with Novocaine.

Which is cheaper?

When comparing both medications, you should pay attention to the fact that their prices are slightly different. Novocaine costs between 19-91 rubles, and Lidocaine - 80-460 rubles. per pack of 10 ampoules.

Pregnancy, lactation and childhood

The product in solution form is not used during pregnancy. Only the use of a spray is allowed, but with extreme caution and only as prescribed by a doctor. It is also undesirable to use Lidocaine during lactation. In such cases, the doctor will find something to replace it with, for example, a more modern analogue of Ultracain DS.

This drug is not used during pregnancy

The anesthetic in question is not used in pediatric dentistry. However, the gel is often recommended for children during painful teething. In this case, it must also be used carefully and subject to strict adherence to the instructions.

Reviews from doctors

Albert Petrovich, neurologist, Novosibirsk: “Some patients mistakenly believe that Novocaine and Lidocaine are the same thing. The substances in their composition are different, so the drugs have their own characteristics. In rare cases, I prescribe them in pairs to relieve acute pain. The use of these medications should be under the supervision of a physician. Lidocaine is an effective anesthetic, but there is a need to first determine the patient’s allergic history.”

Evgeniy Antonovich, cardiologist, Moscow: “Lidocaine effectively relieves pain. It is imperative to adhere to the dosage, because... the drug often causes depression of consciousness and disrupts the heart rhythm. Before use, intradermal and skin tests are performed.”

Andrey Yurievich, surgeon, Moscow: “I consider Novocain an indispensable drug, because it does not disturb the heart rhythm. Often used during surgical interventions. The use of Lidocaine has its own peculiarities; administration into tissues with pronounced vascularization requires caution. For example, in reduced dosages the drug is injected into the neck area during thyroid surgery.”

Anna Vasilievna, dentist, St. Petersburg: “In pediatric practice I use Novocain as a safer remedy. The drug is characterized by sufficient analgesic activity and lower toxicity.”

Features of drug interactions

In order not to provoke side effects, the doctor must select the correct dosage, taking into account the individual characteristics of the patient’s body. It is also important to consider drug interactions, since in combination with certain medications, Lidocaine can cause allergic reactions and accelerate metabolism in the liver.

As a result, such interaction can lead to a decrease in the concentration of the active substance and, as a result, to a decrease in the effectiveness of pain relief. Experts also do not recommend combining this anesthetic with other drugs due to the increased risk of undesirable consequences in the form of central nervous system disorders. Therefore, before starting treatment, the patient must warn the doctor that he is undergoing drug therapy at the same time.

The drug may interact with other drugs

How to inject lidocaine / Docteka.ru

You will need

- syringe;
- needle;
- ampoules;
- sterile cotton wool;
- alcohol.

Instructions

Before using lidocaine solution, perform an intradermal test for possible increased sensitivity of the body to the drug. Use a thin needle to inject a small amount of medication. Evaluate the result after 15 minutes. If the patient is allergic to this drug, swelling and redness will appear in the injection area. In this case, use other anesthetics. If everything is in order, you can use lidocaine for anesthesia.

Prepare a syringe, needle, ampoules, sterile cotton wool and rubbing alcohol.

Take the ampoule and shake it, holding it by the neck. Then squeeze it with your hand and use a circular motion to separate the head. Take the syringe and connect it to the ampoule through the hole formed. Slowly fill it with contents.

For local anesthesia, the drug is administered subcutaneously or intramuscularly. Avoid intravascular administration of the drug. Depending on the parts of the body, use from 40 to 200 mg of the product. For example, to anesthetize the brachial and sacral plexus, use 100-200 mg of lidocaine. If you are dealing with fingers, ears, nose, enter 40-60 mg and so on. The maximum dose for adults is 200 mg.

Wipe the injection site with sterile cotton wool soaked in alcohol and inject. After removing the needle, massage the puncture site with another cotton ball for a few seconds.

Be sure to monitor the ECG while using the drug. In case of any violations, reduce the dose or discontinue the medicine. Use lidocaine with caution if the patient suffers from heart failure, liver disease, kidney disease, hypotension, or a tendency to hyperthermia.

Do not mix lidocaine with other medicines. It precipitates when used with sulfadiazine, methohexitone and amphotericin. Also, the drug may be incompatible with ampicillin.

Contraindications Lidocaine is contraindicated in case of renal and (or) liver failure, individual intolerance, transverse heart block, certain cardiovascular diseases, myasthenia gravis, pregnancy and lactation, etc. Also, it should not be administered to children under 12 years of age.

Side effects When using the drug, dizziness, headache, drowsiness, loss of consciousness, paralysis of the respiratory tract, numbness of the tongue, and decreased blood pressure may occur. In some cases, tachycardia, bradycardia, nausea, vomiting, skin rashes, anaphylactic shock, etc. are observed.

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How much does the drug cost?

A set with ampoules - 10 pieces - costs about 40 rubles. The cost of the drug in carpools is about 70 rubles per piece. For a patient, such anesthesia will cost approximately 300 rubles. The spray costs about 370 rubles per bottle - 50 ml. A gel based on an active ingredient, for example, Kamistad, will cost from 250 rubles.

It should be noted that Lidocaine is also actively used in other areas of medicine. But using it on your own without a doctor’s prescription is not recommended. Like any other medication, it can provoke unwanted reactions if a person has an individual intolerance to the active substances.

1Kucherova, A. N. Local anesthetic properties of lidocaine polyacrylate, 2004.

How to use

The maximum permissible daily dose of Novocaine for an adult is 10 mg per 1 kg of weight. When using adrenaline as a means of prolonging the effect, 15 mg per 1 kg is allowed.

The dosage of Lidocaine is selected individually for the patient. This is due to the fact that this drug is used not only as an anesthetic.

A child under 10 years old can only use Novocain.