Pharmacology - Regional Anesthesia
Below is a summary of commonly used agents in regional anesthesia. Note that some agents are often used for multiple indications. Doses are IV, unless indicated. Also note that less common agents are detailed in the AFMS manual.
The agents are listed with the generic name followed by the trade name in brackets.
Lidocaine (Xylocaine)
- Mechanism
- Voltage-gated Na+ Channel blocker
- Indication
- Peripheral nerve and central neural blockade
- Dosing
- Varies: Max 5 mg/kg or 7mg/kg w/epi
- Considerations
- Usually administered at time of induction to reduce sting of propofol
- Not used for spinal anesthesia due to cases of neurotoxicity; Still used in epidural anesthesia
Bupivacaine (Marcaine)
- Mechanism
- Voltage-gated Na+ Channel blocker
- Indication
- Peripheral nerve and central neural blockade
- Dosing
- Varies: Max 2.0 mg/kg to 3 mg/kg w/epi
- Considerations
- Also used for spinal anesthesia
- Greater cardiotoxicity risk
- More protein-bound, therefore, longer duration of action vs lidocaine
Ropivacaine (Naropin)
- Mechanism
- Voltage-gated Na+ Channel blocker
- Indication
- Peripheral nerve blockade
- Dosing
- o Varies: Max 2.0 mg/kg to 3 mg/kg w/epi
- Considerations
- Similar to Bupivicaine
Next page: Pharmacology - Emergency Medications