Local Anesthetics Flashcards
Esters
Procaine
Chloroprocaine
Tetracaine
Which Ester is most potent?
Tetracaine
Which Ester has the most rapid onset?
Chloroprocaine
Duration after Infiltration: Procaine
45-60min
Chloroprocaine: Duration after infiltration
30-45min
Tetracaine: Duration after Infiltration
60-180min
Procaine: max single dose for infiltration
500mg
Chloroprocaine: max single dose for infiltration
600mg
Tetracaine: max single dose for infiltration
100mg (topical)
Procaine pK
8.9
Chloroprocaine pK
8.7
Tetracaine pK
8.5
Amides
Lidocaine
Prilocaine
Mepivacaine
Bupivacaine
Levobupivacaine
Ropivucaine
Lidocaine: Duration after infiltration
60-120min
Prilocaine: duration after infiltration
60-120min
Mepivacaine: duration after infiltration
90-180min
bupivacaine, levobupivacaine, & ropivacaine duration after infiltration
240-480min
Benzocaine Onset & Duration
onset: rapid
duration: 30-60min
Cocaine peak & duration
peak: 30-45min
duration: 60min after peak
Lidocaine: max single dose for infiltration
300mg
w/ epi: 500mg
spinal: 100mg
Prilocaine: max single dose for infiltration
400mg
mepivacaine: max single dose for infiltration
300mg
Bupivacaine & Levobupivacaine: max single dose for for infiltration
175mg
Ropivacaine: max dose for single infiltration
200mg
Lidocaine & prilocaine pK
7.9
Mepivacaine pK
7.6
Bupivacaine, levobupivacaine, ropivacaine pK
8.1
Benzocaine pK
WEAK ACID - pKa 3.5
Procaine % protein bound
6%
Tetracaine % PB
76%
Lidocaine % PB
70%
Prilocaine % PB
55%
Mepivacaine % PB
77%
Bupivacaine % PB
95% alpha1 acid glycoprotein
levobupivacaine % PB
97%
Ropivacaine % PB
94% alpha1 acid glycoprotein
Procaine lipid solubility
0.6
Tetracaine lipid solubility
80
lidocaine lipid solubility
2.9
Prilocaine lipid solubility
0.9
Mepivacaine lipid solubility
1
Bupivacaine lipid solubility
28
Procaine E 1/2 time:
9 minutes
Chloroprocaine E 1/2 time:
7 minutes
Lidocaine & Prilocaine E 1/2 time:
96 minutes
Mepivacaine E 1/2 time:
114 minutes
Bupivacaine E 1/2 time:
210 minutes
Levobupivacaine E 1/2 time:
156 minutes
Ropivacaine E 1/2 time:
108 minutes
Lidocaine, Prilocaine, and Mepivacaine Toxic Plasma levels
> 5mcg/mL
Bupivacaine toxic plasma level
> 3mcg/mL
Ropivacaine toxic plasma level
> 4mcg/mL
Epi 1:200,000
5mcg/mL
Epi 1:500,000
2mcg/mL
Epi 1:10,000
100mcg/mL
Epi 1:1,000
1000mcg/mL
LA 0.25%
2.5mgs/mL
LA 0.5%
5mgs/mL
LA 1%
10mgs/mL
LA 2%
20mgs/mL
LA 4%
40mgs/mL
Lidocaine Regional Max Dose
- 5mg/kg
- w/ epi: 7mg/kg
Prilocaine Regional Max Dose
- 6mg/kg
- w/ epi: 8.5mg/kg
Mepivacaine Regional Max Dose
- 5mg/kg
- w/ epi: 7mg/kg
Bupivacaine Regional Max Dose
- 2.5mg/kg
- w/ epi: 2.5mg/kg
Ropivacaine Regional Max Dose
- 3mg/kg
- w/ epi: 4mg/kg
Procaine Regional Max Dose
- 7mg/kg
- w/ epi: 8.5mg/kg
Chloroprocaine Regional Max Dose
- 6mg/kg
- w/ epi: 14mg/kg
Tetracaine Regional Max Dose
- 3mg/kg
- w/ epi: 3mg/kg