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Local Anaesthetic

Lidocaine (Topical — Burns/Wounds)

Brand names: EMLA, LMX4, Xylocaine Gel

Topical lidocaine is an amide local anaesthetic applied to burns and wounds to reduce procedural pain, for example during dressing changes or minor debridement.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It reversibly blocks voltage-gated sodium channels in sensory nerve endings, preventing depolarisation and propagation of pain impulses from the treated area.

Prescribing in practice

  • Damaged or denuded skin greatly increases systemic absorption, so limit the treated area and total amount to avoid systemic local-anaesthetic toxicity (perioral numbness, tinnitus, seizures, arrhythmias).
  • Risk of toxicity is higher in children and in patients with hepatic impairment or reduced cardiac output, where clearance is impaired.
  • Be alert to additive effects if other lidocaine-containing or local-anaesthetic products are used concurrently.

Monitoring

Monitor for early features of systemic toxicity when applying to broken or extensive skin, and ensure resuscitation facilities including lipid emulsion are accessible.

Counselling the patient

  • Numbness of the area is expected and protect the anaesthetised skin from heat or injury while sensation is reduced.
  • Report ringing in the ears, dizziness, a metallic taste or numbness around the mouth promptly.

Evidence & guidelines

Systemic local-anaesthetic toxicity is a recognised hazard amplified by application to broken skin, underpinning limits on treated area and total dose.

Reference: BBA (British Burns Association) guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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