When selecting a local anesthetic agent for skin wounds lidocaine is used for a faster onset, and bupivacaine for a longer duration of action. It can be time-consuming to find 0.5% Bupivacaine with epinephrine and 2% Lidocaine with Epinephrine to produce a final mixture of 1% Lidocaine and 0.25% Bupivacaine with Epinephrine. There is a dearth of good evidence for the speed of onset, and duration of anesthesia when using Lidocaine and Bupivacaine.
There are no studies comparing the pain of infiltration between Lidocaine and Bupivicaine. Studies comparing these 2 agents for digital nerve blocks have found a significant reduction in pain of injection in mixtures that do not contain Bupivacaine. Two studies evaluated time of onset, and duration of anesthesia for Lidocaine, Lidocaine with Epinephrine, Bupivacaine, Bupivacaine with Epinephrine, Lidocaine and Bupivacaine with Epinephrine, and…
