1. The efficacy profile of lidocaine as a local anesthetic is characterized by a rapid onset of action and 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 subdural and epidural anesthesias; lidocaine, though, has the advantage of a rapid onset of action.
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2.
For surface anesthesia, several available
formulations can be used e.g. for endoscopies, before intubations, etc. Buffering the pH of lidocaine
makes local freezing less painful. Lidocaine drops can be used on the eyes for short ophthalmic
procedures.
3. Relative insensitivity to lidocaine is genetic. In hypokalemic sensory overstimulation, relative
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insensitivity to lidocaine has been described in people who also have attention deficit hyperactivity
disorder.In dental anesthesia, a relative insensitivity to lidocaine can occur for anatomical reasons
due to unexpected positions of nerves. Some people with Ehlers-Danlos syndrome are insensitive to lidocaine.
4. Lidocaine, along with ethanol, has also been proven to be effective in
treating jellyfish stings, both numbing the affected area and preventing further nematocyst discharge.
Lidocaine is a local anesthetic commonly used in medical clinic, which was used to treat heart arrhythmia in 1963. It is currently the drug to prevent and treat acute myocardial infarction and various heart diseases complicated by rapid ventricular arrhythmia, and is the preferred drug for premature ventricular beat, ventricular tachycardia and ventricular tremor of acute myocardial infarction.
Inflammations of the external auditory canal number among the most frequently occurring ear-nose-throat diseases. For local treatment, substances from various groups of active ingredients are used as combinations and as single-agent drugs, e.g. antibiotics, glucocorticoids or analgesics [1]. In the case of acute otitis externa, treatment measures focus on the reduction of pain and swelling. The study described here investigates the efficacy and safety of glycerol lidocaine eardrops for the treatment of acute abacterial otitis externa (CAS No. for glycerol: 56-81-5, lidocaine-HCl: 73-78-9). In this double-blind, three-arm study, 105 patients diagnosed with acute abacterial otitis externa were included and randomized to receive either glycerol eardrops, glycerol eardrops with 0.5% lidocaine, or glycerol eardrops with 2% lidocaine for seven days. The primary outcome parameter was the change of the five typical clinical symptoms, earache, itching, otorrhea, hearing impairment, and "clogged ear" at Visit 2 (Day 7) based on the initial examination on Day 0. Both therapy groups treated with a combination of glycerol and lidocaine exhibited definite improvement in overall symptoms after seven days. This improvement differed from the mild reduction of symptoms under treatment with glycerol eardrops alone. Overall improvement of symptoms, expressed by the area under the curve of the baseline-adjusted symptom sum score, yielded a mean value of 10.95 (standard deviation 27.4) for the morning survey of the groups receiving eardrops containing only glycerol; in comparison, for eardrops containing glycerol and 2% lidocaine it was 15.71 (+/- 23.6) and for glycerol with 0.5% lidocaine, 23.16 (+/- 19.4). No severe adverse events occurred. Five adverse events were documented during the clinical investigation, none of which was considered by the investigators to be related to the study medication. Local therapy with glycerol lidocaine eardrops is a safe, and cost-effective treatment for the widely spread clinical picture of acute abacterial otitis externa. The advantage regarding efficacy of this combination compared with glycerol eardrops must be demonstrated in an adequately powered clinical trial.
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