Overview
Etidocaine is a long-acting amide local anesthetic with rapid onset and prolonged duration of action, primarily used for regional anesthesia. It has been largely replaced by newer agents in many markets due to its higher potential for cardiotoxicity.
Mechanism of Action
Blocks voltage-gated sodium channels in neuronal membranes, inhibiting depolarization and preventing propagation of action potentials, thereby producing local anesthesia.
Indications
- Infiltration anesthesia
- Peripheral nerve blocks
- Epidural anesthesia
- Caudal anesthesia
Dosage
Dosage varies by procedure, patient status, and anesthetic technique. Maximum recommended dose: 300 mg (4 mg/kg) without epinephrine; 400 mg (5.5 mg/kg) with epinephrine.
Contraindications
- Hypersensitivity to amide local anesthetics
- Severe hepatic impairment
- Heart block
- Hypotension
- Local infection at injection site
Side Effects
- Hypotension
- Bradycardia
- Nausea/vomiting
- Dizziness
- Paresthesia
- Methemoglobinemia (rare)
- CNS excitation/depression
- Cardiac arrhythmias
Interactions
- MAO inhibitors (increased hypotension risk)
- Beta-blockers (increased cardiovascular depression)
- Other local anesthetics (additive toxicity)
- Antiarrhythmics (increased cardiac effects)