Lidocaine: A Comprehensive Pharmacological Report

1. Introduction to Lidocaine

1.1. Overview and Historical Context

Lidocaine, also known by its alternative name lignocaine, stands as a cornerstone medication in modern medicine, primarily recognized for its efficacy as an amino amide-type local anesthetic and as a Class Ib antiarrhythmic agent.[1] Its discovery in 1943 by Swedish chemists Nils Löfgren and Bengt Lundqvist, and subsequent introduction to the market around 1948-1949, represented a significant advancement in pharmacology.[2] Compared to its predecessors, such as procaine (Novocain), lidocaine offered a more rapid onset of action, greater potency, and a considerably lower potential for allergic reactions, leading to its swift adoption in clinical practice.[1] The initial brand name for lidocaine was Xylocaine.[5]

The enduring clinical relevance of lidocaine, decades after its introduction, is a testament to its favorable balance of efficacy, safety (when used appropriately), and cost-effectiveness. This is particularly evident when considering its widespread use for fundamental anesthetic needs and specific cardiac arrhythmias, where newer agents have not universally surpassed its utility. This long-standing prominence is further underscored by its consistent inclusion in the World Health Organization's (WHO) List of Essential Medicines, signifying its critical role in basic healthcare systems globally.[1] As an indicator of its continued importance, lidocaine was the 262nd most commonly prescribed medication in the United States in 2022.[2] The early and extensive clinical experience gained under the Xylocaine brand likely established a strong foundation of trust and familiarity among medical practitioners, contributing to its sustained use even after the advent of generic versions.[5] This illustrates how initial market presence and robust branding can significantly influence a drug's long-term therapeutic legacy.