ointment containing lidocaine is used topically in treatment of burns and abrasions, as
well as for minor dermatological, anorectal, and otological conditions.
c. Administration. Lidocaine solutions of 0.5 percent, often combined with
epinephrine, are usually administered for infiltration anesthesia. Solutions of 1percent
to 2 percent are used to produce nerve block. For topical anesthesia, 2 percent to 5
percent preparations are used. A 1 percent solution is generally used for peridural
d. Untoward Effects. Central nervous system stimulation followed by
depression may occur as with the use of procaine. In addition, a drowsy, sleepy state
may occur as an aftereffect of the use of lidocaine.
e. Cautions and Contraindications. Care should be taken not to administer
the drug intravenously. The commercially prepared lidocaine-epinephrine solution
should not be withdrawn ahead of time. This preparation should be injected
immediately upon its withdrawal into a syringe. Lidocaine preparations deteriorate at or
before 36 months from the date on the package, and they are damaged by freezing.
f. Supply. Lidocaine hydrochloride is supplied in 0.5 percent to 2 percent
solutions, with and without epinephrine, and as a 2 percent jelly. Lidocaine is also
available as a 5 percent ointment.
2-42. DIBUCAINE OINTMENT
a. Action and Uses. Dibucaine (Nupercaine) is the most potent, most toxic,
and the longest acting of the local anesthetic agents available as standard items. It is
about 15 times as potent and as toxic as procaine; its anesthetic action lasts about 3
times as long as that of procaine. The drug is employed topically for the relief of pain
associated with conditions such as sunburn and hemorrhoids.
b. Administration. For topical application a 1 percent ointment is used, and it is
applied to the painful surface.
c. Cautions and Contraindications. Caution should be exercised in the use of
this drug because of its potential toxicity.
d. Supply. Dibucaine is supplied as a 1 percent ointment with rectal applicator.
Tetracaine hydrochloride (Pontocaine Hydrochloride) is an all-purpose anesthetic
with a longer duration of action than procaine. Found in field sets are tetracaine
hydrochloride ophthalmic solution (0.5 percent) and tetracaine ointment (0.5 percent).