The effect of lidocaine when used as a local anesthetic or by intravenous injection

The efficacy profile of lidocaine as a local anesthetic is characterized by a rapid onset of action and an intermediate duration of efficacy. Therefore, lidocaine is suitable for infiltration, block, and surface anesthesia. Longer-acting substances such as bupivacaine are sometimes given preference for spinal and peridural anesthesias, however, lidocaine, on the other hand, has the advantage of a rapid onset of action. Adrenaline supplements could delay the resorption and the duration of efficacy could be doubled. Lidocaine is the most important class 1B antiarrhythmic drug: it is used intravenously for the treatment of ventricular arrhythmias (for acute myocardial infarction, digitalis poisoning, cardioversion, or cardiac catheterization). However, a routine prophylactic administration is no longer recommended for acute cardiac infarction. The overall benefit of this measure is not convincing. Lidocaine has also been efficient in refractory cases of status epilepticus.