Onset and duration of intradermal mixtures of bupivacaine and lidocaine with epinephrine

James B. Collins, Juhee Song, Raman C. Mahabir

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background/objective: Bupivacaine and lidocaine are often used concurrently, in theory, to combine the more rapid onset of lidocaine and the longer duration of bupivacaine. The purpose of this study was to evaluate this concept. Methods: Twenty-five subjects were enrolled in a double-blinded, randomized block design study to evaluate the onset and duration of four different mixtures of lidocaine and bupivacaine with epinephrine. The study was designed to achieve 80% power to detect an effect size of 0.37 at 5% overall significance. The four mixtures tested were: 0.25% bupivacaine with epinephrine (1:200,000); 1% lidocaine with epinephrine (1:100,000); 0.125% bupivacaine and 0.5% lidocaine with epinephrine (1:150,000); and 0.25% bupivacaine and 1% lidocaine with epinephrine (1:150,000). Four intradermal injections were made in the volar forearms of each participant. Time to effect and duration were measured by sensation of a sharp skin prick. Results: Mean time to onset ranged from 12 s to 29 s without statistical significance across all tested solutions (P=0.891). Mean duration of effect ranged from 6 h 38 min to 7 h 25 min with a statistically significant difference across the tested solutions (P=0.036). Conclusions: No statistical benefit was measured when comparing lidocaine with epinephrine, bupivacaine with epinephrine, and mixtures of these local anesthetics with regard to onset of action. While a statistical difference was observed in duration of effect, the clinical benefit measured was narrow.

Original languageEnglish (US)
Pages (from-to)51-53
Number of pages3
JournalCanadian Journal of Plastic Surgery
Volume21
Issue number1
StatePublished - Mar 2013
Externally publishedYes

Fingerprint

Bupivacaine
Lidocaine
Epinephrine
Intradermal Injections
Local Anesthetics
Forearm
Skin

Keywords

  • Bupivacaine
  • Duration
  • Lidocaine
  • Local anesthetic
  • Onset

ASJC Scopus subject areas

  • Surgery

Cite this

Onset and duration of intradermal mixtures of bupivacaine and lidocaine with epinephrine. / Collins, James B.; Song, Juhee; Mahabir, Raman C.

In: Canadian Journal of Plastic Surgery, Vol. 21, No. 1, 03.2013, p. 51-53.

Research output: Contribution to journalArticle

Collins, James B. ; Song, Juhee ; Mahabir, Raman C. / Onset and duration of intradermal mixtures of bupivacaine and lidocaine with epinephrine. In: Canadian Journal of Plastic Surgery. 2013 ; Vol. 21, No. 1. pp. 51-53.
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