Local

Lidocaine (Xylocaine ) rapid onset; shorter acting

Bupivacaine (Marcaine, Sensorcaine) longer acting; longer analgesia after return of sensation

Tetracaine (Pontocaine) rapid onset; Longer acting with higher dosage and/or added ephedrine or epinephrine

Ropivacaine (Naropin) as per bupivacaine but less toxic

Mepivacaine (Polocaine) as per bupivacaine

Cocaine rapid onset; ophthalmic use mucous membranes (anorectal)

Caution All conduction anesthetic agents, when administered in greater than recommended dosages or if accidentally given intravenously (or by idiosyncratic reaction), may cause extreme agitation, convulsions, cardiac arrest, and death. Resuscitative equipment and drugs must be immediately available whenever these agents are employed. The dosages of agents listed in this table are approximate, modified by the patient’s weight, height, duration of the procedure (with incremental doses), and cardiac arrhythmias. Vasoconstrictors such as ephedrine and epinephrine can be added to an anesthetic agent to prolong the effect of the block. A diffusing agent such as hyaluronidase (Wydase) may be added to local anesthetics to hasten the onset of the anesthetic effect. This table lists only several of the most commonly used anesthetic agents in the dosages used primarily for adult patients.