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The Nationwide Shortage of Local Anesthesia Lidocaine – What Can Be Done?

Due to the COVID-19 pandemic, many manufacturers of lidocaine [local anesthetic] are experiencing supply chain delays that may last for months to years.”
— Tanya Shenoy, BS
JACKSON, MISSISSIPPI, US, September 15, 2022 / -- Local anesthetics such as lidocaine are very important for ensuring patient comfort during medical procedures. They are very commonly used in Dermatology for a variety of procedures, including biopsies and removal of skin cancer. Due to the COVID-19 pandemic, many manufacturers of lidocaine in the United States are experiencing supply-chain delays that may last for months to years. Therefore, it is prudent for healthcare providers to use their supplies efficiently to avoid exhausting supplies.

In this new study in SKIN: The Journal of Cutaneous Medicine®, Tanya Shenoy and co-authors suggest several ways to maximize the available supply of lidocaine. They point out that 0.5% lidocaine provides the same amount of pain control as 1.0% lidocaine, so providers can dilute the lidocaine to this concentration without affecting patient comfort. Another technique they recommend is adding sodium bicarbonate to the anesthetic. Lidocaine is known to be acidic and therefore cause a burning sensation when administered. Many providers already buffer lidocaine in a 9:1 ratio to sodium bicarbonate. However, using a 3:1 or 5:1 ratio can minimize pain more effectively and reduce the volume of lidocaine used.

In addition to these and other methods to maximize the available supply of lidocaine, the authors also suggest alternatives to lidocaine for pain control. These include using other commonly used anesthetics such as bupivacaine, procaine, or tetracaine. Additionally, antihistamines such as diphenhydramine can be an effective anesthetic for simple procedures. By utilizing these tips, healthcare providers can help mitigate the effects of the lidocaine shortage and ensure adequate pain control during important medical procedures.

DOI: 10.25251/skin.5.5.17

SKIN: The Journal of Cutaneous Medicine® is a peer-reviewed online medical journal that is the official journal of The National Society for Cutaneous Medicine. The mission of SKIN is to provide an enhanced and accelerated route to disseminate new dermatologic knowledge for all aspects of cutaneous disease.

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Tanya Shenoy, BS
University of Mississippi School of Medicine