This page shows what was measured, who it was measured in, and what that does not settle.
What Lidocaine does in the body
Numbing part of the body for a procedure, and steadying a dangerously fast heart rhythm
Nerves send messages by letting sodium flood in through tiny gates. Lidocaine slips through the nerve membrane in its uncharged form, picks up a proton inside, and then sits in the mouth of the gate from the inside so sodium cannot pass. Nerves that are firing fastest are blocked first, which is why pain fibres go numb before the nerves that move your muscles. When the drug diffuses away, the gates work again and feeling comes back, with nothing changed.
What happened in people
A standardised mean difference in postoperative pain at 24 hours of -0.14 across 33 trials and 1,847 participants — real, and smaller than the review's own threshold for meaning anything
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The recorded finding that sits closest to something a person would notice. Written into the record, not signed off, and it carries no population or interval.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
The limit that matters most
Demoted from first-line to second-line antiarrhythmic in cardiac arrest guidelines after ALIVE, then left there by ALPS showing amiodarone does not beat placebo either
Where it acts
Cytoplasmic face of the sodium channel pore, in peripheral nerve axons and cardiac ventricular myocytes
Kind of result
Symptoms and quality of life
Supervision
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
What the registries record it as
The substance registry classes this as chemical.
FDA substance registry · 98PI200987 · read 2026-08-29
Where each sentence above came from
No recorded sentence describes the change this makes in a way that stands on its own. The page opens with what it is taken for instead, and the recorded explanation follows below.
Shown as the opening line on this page.
A limit recorded against this substance. Not signed off as a reviewed claim.
The four opening statements run to 128 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Confidence interval
A confidence interval is the range the true answer is likely to sit in.
A picture of it, and where the picture fails
It is like a weather forecast giving a range rather than one number.
Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.
What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.
An interval estimate that would contain the true parameter in a stated proportion of repeated studies.
Receptor
A receptor is a part of a cell that a signal fits into.
A picture of it, and where the picture fails
A receptor is like a lock waiting for one key.
Where that stops being true. A lock either opens or does not. A receptor can be half-triggered, or worn out.
What people get wrong. Fitting a receptor is read as causing a benefit. It causes a step, and nothing more.
A protein that binds a specific ligand and converts that binding into a cellular response.
Pathway
A pathway is a chain of steps inside a cell, each one setting off the next.
A picture of it, and where the picture fails
A pathway is like a row of dominoes.
Where that stops being true. Dominoes fall one way. Pathways loop back and can switch themselves off.
What people get wrong. Changing one step is read as changing the outcome. Other steps often absorb it.
An ordered series of molecular interactions producing a defined cellular change.
What happened in people◇Read from sources, not yet reviewed
What was measured, goal by goal
One row for each goal a registered study measured something for. One column for each kind of thing that could be measured.
Registered studies list 40 outcome measures that RNAWiki could read. A registered study says what someone planned to measure. It does not say what they found. 0 of the matched studies tested this substance, and 0 posted a result.
There is no single score. A strong test result and a weak life result are different facts.
Goals down the side, kinds of measurement across the top. Each cell says what kind of thing was registered, not what was found.
Goal
Life outcome
What a body can do
How a person feels
A test result
A step in the body
Harms
How long
Who was studied
Pain
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
…Waiting for a reviewer18 registered symptom measure.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Energy
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
…Waiting for a reviewer1 registered symptom measure.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Healthy ageing
…Waiting for a reviewer1 registered study measure of this kind. No reviewed result yet.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Focus
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Mood
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
…Waiting for a reviewer1 registered symptom measure.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Recovery
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Which registered measures put each goal on this table
Pain
pain intensity rating; pain; pain scores; intensity of pain; pain perception; average daily pain intensity; pain intensity; assessment of immediate post injection pain severity by
Energy
fatigue scores
Healthy ageing
mortality
Focus
montreal cognitive assessment
Mood
hamilton depression scale
Recovery
quality of recovery 40
Sorted by fixed word lists, version v1. A name the rules do not recognise stays unsorted rather than moving to the nearest column.
What each mark on this table means
∅ Nothing in the sources checked
No registered study lists a life outcome for this goal.
… Waiting for a reviewer
18 registered symptom measure.
— Not recorded
Harms were not a registered measure for this goal.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Survival to hospital discharge after out-of-hospital cardiac arrest
✗ The study did not show it
Who was studied
ALPS — Amiodarone, Lidocaine or Placebo Study (NCT01401647)
P = 0.16 for lidocaine versus placebo (23.7% versus 21.0%, difference 2.6 percentage points, 95% CI -1.0 to 6.3)
Repeated elsewhere
Unreplicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Treatment effect was heterogeneous by whether the arrest was witnessed (P=0.05); the benefit of active drug over placebo was confined to bystander-witnessed arrests and absent in unwitnessed ones.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Injection for infiltration, nerve block, epidural and spinal use; intravenous solution for arrhythmia; topical gel, cream, ointment, spray, jelly and 5% medicated patch
Interval reported. 95% CI -1
Written into the record, not signed off as a reviewed claim.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
Proportion of patients surviving to hospital admission
✗ The study did not show it
Who was studied
ALIVE — Amiodarone versus Lidocaine In prehospital ventricular fibrillation
How many people
347
Study design
Randomised double-blind active-controlled trial
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
P = 0.009 in favour of amiodarone (22.8% of 180 versus 12.0% of 167; odds ratio 2.17, 95% CI 1.21 to 3.83)
Repeated elsewhere
Partially Replicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. There was no placebo arm. The trial shows lidocaine is worse than amiodarone and says nothing about whether either beats no drug.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Injection for infiltration, nerve block, epidural and spinal use; intravenous solution for arrhythmia; topical gel, cream, ointment, spray, jelly and 5% medicated patch
Interval reported. 95% CI 1
Written into the record, not signed off as a reviewed claim.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
MacMahon pooled analysis of prophylactic lidocaine in suspected acute MI
How many people
9155
Study design
Meta-analysis of 14 randomised trials
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
Odds of ventricular fibrillation reduced about one third (95% CI 3% to 56% reduction); odds of early death about one third greater (95% CI 2% reduction to 95% increase)
Repeated elsewhere
Replicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Only 103 fibrillation events and 137 deaths across all 14 trials, so the mortality estimate is imprecise in both directions. The authors said so.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Injection for infiltration, nerve block, epidural and spinal use; intravenous solution for arrhythmia; topical gel, cream, ointment, spray, jelly and 5% medicated patch
Interval reported. 95% CI 3% to 56% reduction); odds of early death about one third greater (95% CI 2% reduction to 95% increase)
Written into the record, not signed off as a reviewed claim.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
Pain score at rest, gastrointestinal recovery and adverse events after surgery
✗ The study did not show it
Who was studied
Weibel Cochrane review of perioperative intravenous lidocaine infusion
How many people
4525
Study design
Systematic review and meta-analysis of 68 randomised trials
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
SMD -0.14 (95% CI -0.25 to -0.04) at 24 hours and -0.11 (95% CI -0.25 to 0.04) at 48 hours; both moderate quality and both below the review's threshold for clinical relevance
Repeated elsewhere
Partially Replicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Only a small number of the 68 trials systematically analysed adverse events, so the safety side of the comparison is graded very low quality.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Injection for infiltration, nerve block, epidural and spinal use; intravenous solution for arrhythmia; topical gel, cream, ointment, spray, jelly and 5% medicated patch
Interval reported. 95% CI -0
Written into the record, not signed off as a reviewed claim.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
Participants with at least 30% or 50% pain intensity reduction
✗ The study did not show it
Who was studied
Derry Cochrane review of topical lidocaine for neuropathic pain
How many people
508
Study design
Systematic review of 12 randomised double-blind studies
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
No pooling possible. No first-tier or second-tier evidence; every included study judged at high risk of bias.
Repeated elsewhere
Unreplicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Enriched-enrolment randomised-withdrawal designs, used in two of the twelve, cannot measure the real impact of adverse events because intolerant participants are removed before randomisation.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Injection for infiltration, nerve block, epidural and spinal use; intravenous solution for arrhythmia; topical gel, cream, ointment, spray, jelly and 5% medicated patch
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
RNAWiki holds 5 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What happened in people◇Read from sources, not yet reviewed
How close this is to real life
The top step is something a person would feel or care about. The bottom is a guess from software. Filled steps are where evidence exists for this substance.
■Living longer, or avoiding a major eventEvidence recorded. Death, a heart attack, a stroke, a hospital stay.1 registered measure of this kind. 3 written-up studies measured this and did not show a benefit.
□What a body can do day to dayNo evidence recorded. Walking, dressing, breathing, recovering.No registered study measures this.
□Measured performanceNo evidence recorded. How much was lifted, how far was run, how fast.No registered study measures this.
■Symptoms and quality of lifeEvidence recorded. Pain, tiredness, mood, sleep, as the person rated it.20 registered measures of this kind.
□A number that stands in for healthNo evidence recorded. Cholesterol, blood sugar, bone density. A stand-in, not the thing itself.No registered study measures this.
■A step measured inside a personEvidence recorded. Something measured in human tissue or human cells.A human record sits on the stored organism ladder.
■AnimalsEvidence recorded. Mice, rats, dogs. Useful for ideas, not proof about people.Stored records in Mouse, Rat, Dog. A result in animals says what to test next. It does not say what happens in people.
■Cells in a dishEvidence recorded. Cells or chemistry on a bench, far from a whole body.Stored mechanism abstracts describe steps measured in cells or tissue.
□A guess from softwareNo evidence recorded. Nobody measured it. RNAWiki never publishes one as a finding.RNAWiki stores no prediction for this record. Software can suggest a link. RNAWiki does not publish one as a finding.
Higher on these steps means closer to something a person would feel. It does not mean better done.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Lidocaine
What a person takes: Injection for infiltration, nerve block, epidural and spinal use; intravenous solution for arrhythmia; topical gel, cream, ointment, spray, jelly and 5% medicated patch.
The measurement behind this step
The route decides the drug. An infiltration injection is meant to stay in the tissue and act on nearby nerves; an intravenous infusion is meant to reach the heart or the whole body. Many injectable presentations are co-formulated with adrenaline, which constricts local vessels, slows washout and lengthens the block. Preservative-free presentations exist because preservatives are not acceptable in the epidural or spinal space.
Getting in
Injected, or laid on the skin, and it stays where it is put
The drug is placed next to the nerve that needs silencing. It works on the tissue it touches, and the block wears off as blood carries it away.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Duration of a peripheral block is governed by local clearance rather than by elimination half-life, which is why adrenaline is co-formulated in many presentations: vasoconstriction slows washout and lengthens the block. Systemically the drug is cleared by hepatic CYP1A2 and CYP3A4 to monoethylglycinexylidide and glycinexylidide, both of which are pharmacologically active.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
Reaching the cell
It crosses the nerve membrane uncharged, then picks up a proton inside
Only the electrically neutral form can slip through the fatty nerve membrane. Once inside, the more acidic interior puts a charge back on it, and the charged form is the one that blocks.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The tertiary amine has a pKa near 7.9, so at physiological pH roughly a quarter of the molecule is neutral and available to permeate. Inflamed tissue is acidic, which shifts the equilibrium toward the charged species outside the cell and is the accepted explanation for why local anaesthesia works poorly in an abscess.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
What it acts on
It plugs the sodium gate from the inside
The blocking site is on the inner face of the channel, not the outer one. The drug sits in the mouth of the pore and sodium ions cannot get past it.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The receptor lies in the inner pore, formed principally by segment S6 of domain IV. Ragsdale and colleagues showed that the F1764A substitution cuts open-and-inactivated-state affinity to 1% of wild type; the permanently charged analogue QX-314 blocks only when applied intracellularly, which is the classical demonstration that the site faces the cytoplasm.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
The change it makes
Busy nerves are blocked harder than quiet ones
Every time the gate opens the drug gets another chance to bind, so nerves firing rapidly accumulate block far faster than nerves at rest. Pain fibres fire fast, which is why they go first.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Use-dependent, or phasic, block arises because affinity for the open and inactivated conformations is orders of magnitude higher than for the resting one. The same property underlies the class Ib antiarrhythmic action: an ischaemic, rapidly depolarising ventricle spends more time in the inactivated state than healthy myocardium and is blocked preferentially.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
What that does for a person
The action potential fails and the message never leaves
With enough gates blocked, the electrical wave cannot rebuild itself further along the nerve. The signal dies where it started and no pain reaches the brain.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Block reduces the peak sodium conductance below the threshold needed for regenerative propagation. Conduction fails first in small unmyelinated C fibres and small myelinated A-delta fibres, then in the larger A-beta and A-alpha fibres, producing the clinical sequence of pain, then temperature, then touch, then motor loss, and the reverse sequence on recovery.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
What that does for a person
It diffuses away and everything returns exactly as it was
Nothing is consumed and nothing is permanently changed. When the drug leaves, the gates open normally again and sensation comes back.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Binding is fully reversible and the channel protein is not modified. Recovery of conduction tracks local concentration decay rather than any repair process, which is what separates a local anaesthetic from a neurolytic agent such as phenol or alcohol.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 6 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What it would be like to take◇Read from sources, not yet reviewed
Felt, measured, or meaningful
Three different things that get called the same word. Registered studies measured all three, and mixing them is how a blood test becomes a health claim.
Felt
Things a person could notice without a test.
pain intensity rating
pain
pain scores
fatigue scores
intensity of pain
pain perception
average daily pain intensity
pain intensity
assessment of immediate post injection pain severity by
hamilton depression scale
and 10 more.
Measured
Things only a test, a scale or a device shows.
No registered study measured anything of this kind.
Meaningful
Things that change how a life goes, not only a number.
mortality
A registered study says what someone planned to measure. It does not say what they found. A number moving is not the same as a life going better. The two are shown apart here.
Felt, but not shown to help. A person notices a change. No study showed it leads anywhere good.
Measured, but not felt. A number moves. The person notices nothing. Both can be true.
Measured, but not shown to matter. A number moves in the good direction. Nobody showed that lives went better.
Matters, but takes years. The result that counts may take longer than anyone would keep watching.
Names that fit none of the three (19)
amplitude of the vasomotor response to stimuli
resolution of symptoms
severity of airway interruption
quality of operative field
area under the curve
clinical response rate
extension of florscein paint on the cornea and conjunctiva
total sedation time
hospital stay
treatment success event rates in each group
atrial fibrillation
mini mental state examination
montreal cognitive assessment
clinical dementia rating
fentanyl consumption
opiate consumption
quality of recovery 40
visual analogue scale
post operative narcotic use
These are harms, study-process measures, or names the rules did not recognise. They are shown rather than dropped.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
Almost everyone who has had a filling, a stitch, a mole removed, an epidural or a skin biopsy. It is on the WHO Model List of Essential Medicines as both a local anaesthetic and an antiarrhythmic.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “Safety and effectiveness in pediatric patients have not been established.”
US prescribing information · a1b17507-4560-490d-a388-74e7fd7eaa5e · read 2026-08-30
On older people, the label states: “Clinical studies of ZTLIDO did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.”
US prescribing information · a1b17507-4560-490d-a388-74e7fd7eaa5e · read 2026-08-30
On people who are pregnant, the label states: “Risk Summary The limited human data with lidocaine in pregnant woman are not sufficient to inform drug-associated risk for major birth defects and miscarriage.”
US prescribing information · a1b17507-4560-490d-a388-74e7fd7eaa5e · read 2026-08-30
On people who are breastfeeding, the label states: “Risk Summary Lidocaine is excreted into human milk.”
US prescribing information · a1b17507-4560-490d-a388-74e7fd7eaa5e · read 2026-08-30
Where the result stopped carrying
ALPS: no significant survival benefit over saline placebo in the largest antiarrhythmic trial ever run in cardiac arrest
ALIVE: lidocaine lost the head-to-head against amiodarone on survival to admission, P=0.009
Routine prophylactic lidocaine after myocardial infarction was abandoned worldwide after the 1988 pooled analysis
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied for a different goal
The studies measured something else entirely.
On this record: Some registered studies measured things that match no goal on this page.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (10)
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Given by a clinician
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Injection for infiltration, nerve block, epidural and spinal use; intravenous solution for arrhythmia; topical gel, cream, ointment, spray, jelly and 5% medicated patch
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Suppression classes recorded: S1, S6.
No source is stored against this line.
What is in the pack
The route decides the drug. An infiltration injection is meant to stay in the tissue and act on nearby nerves; an intravenous infusion is meant to reach the heart or the whole body. Many injectable presentations are co-formulated with adrenaline, which constricts local vessels, slows washout and lengthens the block. Preservative-free presentations exist because preservatives are not acceptable in the epidural or spinal space.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold and what that means for what is in the pack.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
The label warns of methaemoglobinaemia, with higher susceptibility in glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methaemoglobinaemia, cardiac or pulmonary compromise, infants under six months and concurrent oxidising agents. Systemic toxicity from inadvertent intravascular injection or excessive dose progresses through circumoral numbness, tinnitus and metallic taste to seizures and, at higher exposure, cardiac depression. The topical patch label warns that serious burns have been reported with products of this type and that more than one patch should not be worn at a time. Lidocaine is the least cardiotoxic of the commonly used amide anaesthetics, which is why it is the one chosen where an intravascular injection is most likely.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
ALPS — Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study registration record (NCT01401647) · a recorded source, not a stored snapshot
Reports sent to a regulator
These are reports people sent to a regulator. They do not show the medicine caused the reaction.
Nobody counted how many people took the medicine and reported nothing.
The same event can be reported more than once, and many reports are incomplete.
News coverage, lawsuits and new warnings change how often people report.
A count is not a rate and not a risk.
Lidocaine appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 3152 reaction mentions were counted. One report can name several reactions.
The recorded terms (10)
drug hypersensitivity — 484 reaction mentions
hypotension — 456 reaction mentions
toxicity to various agents — 392 reaction mentions
anaphylactic reaction — 379 reaction mentions
anaphylactic shock — 289 reaction mentions
bradycardia — 267 reaction mentions
cardiac arrest — 254 reaction mentions
tachycardia — 222 reaction mentions
loss of consciousness — 219 reaction mentions
methaemoglobinaemia — 190 reaction mentions
open-targets-adr · recorded 2026-06-24 · a recorded source, not a stored snapshot
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Injection for infiltration, nerve block, epidural and spinal use; intravenous solution for arrhythmia; topical gel, cream, ointment, spray, jelly and 5% medicated patch
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
An infiltration injection is meant to stay in the tissue and act on nearby nerves; an intravenous infusion is meant to reach the heart or the whole body. Many injectable presentations are co-formulated with adrenaline, which constricts local vessels, slows washout and lengthens the block. Preservative-free presentations exist because preservatives are not acceptable in the epidural or spinal space.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on which forms are sold and how they compare.
No source is stored against this line.
What is recorded as being sold
1833 products list this as an active ingredient in the United States drug directory. 1300 of them contain it and nothing else.
FDA National Drug Code directory · 0409-4713 · read 2026-08-29
They are sold as aerosol, foam, aerosol, spray, cloth, cream, emulsion and gel, taken auricular (otic), cutaneous, epidural and extracorporeal.
FDA National Drug Code directory · 0409-4713 · read 2026-08-29
The regulator's established pharmacologic class for it is amide local anesthetic [epc], amides [cs] and antiarrhythmic [epc].
FDA National Drug Code directory · 0409-4713 · read 2026-08-29
1681 published labels name it as an active ingredient. 1167 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · 59c8b33a-7d4f-2c6e-e063-6394a90a7929 · read 2026-08-29
Those labels are classed as human otc drug and human prescription drug.
US prescribing information · 59c8b33a-7d4f-2c6e-e063-6394a90a7929 · read 2026-08-29
1 marketed supplement label lists this ingredient, classed as non-nutrient/non-botanical.
Those labels carry all other and structure/function claims. A claim of that kind is written by the manufacturer and is not assessed by any regulator, so its presence says nothing about whether it is true.
Ztlido is topical at 3 DOSAGE FORMS AND STRENGTHS Topical system: 1.8% packaged in an individual envelope., recorded as fda label in effect 2024-11-01 in the United States.
US prescribing information · a1b17507-4560-490d-a388-74e7fd7eaa5e · read 2026-08-30
Recorded price in US: 0.05171–0.59693 USD per one gram, across 30 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Recorded price in US: 0.05423–3.23817 USD per one millilitre, across 74 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Recorded price in US: 1.13768–2.03101 USD per one unit as the pricing file counts it — a tablet, capsule, patch or single item, across 17 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
Self-experiment planning is not offered for a prescription or clinician-supervised medicine. The questions below are for a clinician or pharmacist.
Questions worth asking
Which of the trials of Lidocaine studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That suppressing ventricular fibrillation with prophylactic lidocaine after myocardial infarction saves lives — the pooled trials trended the other way on death
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the 5% patch is an established neuropathic pain treatment — the Cochrane review found no first-tier or second-tier evidence at all across 12 studies and 508 participants
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That perioperative lidocaine infusion meaningfully reduces postoperative pain, ileus or opioid use — every one of those outcomes was graded very low quality
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the reliability of lidocaine as a local anaesthetic transfers to its systemic uses; they are different concentrations acting on different tissue for different purposes
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Lidocaine are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
The receptor site is a single pore-lining phenylalanine, and mutating it away works
In plain words
Researchers changed one amino acid deep inside the sodium channel and local anaesthetics almost stopped working on it. That is the cleanest evidence there is that the drug acts where it is said to act.
What was measured
Fold change in open and inactivated state binding affinity after single-residue substitution in DIV-S6
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Ragsdale, McPhee, Scheuer and Catterall made site-directed mutations in transmembrane segment S6 of domain IV of the rat brain sodium channel alpha subunit and expressed them in Xenopus oocytes. Mutation F1764A, near the middle of the segment, reduced affinity of the open and inactivated channel to 1% of wild type and almost completely abolished both the use-dependence and the voltage-dependence of block. N1769A increased resting-state affinity 15-fold. I1760A opened an access route for drug to reach the site from outside the cell. Together the three mutations locate the local anaesthetic receptor inside the channel pore and identify the residues that make binding state-dependent.
Written into the record, not signed off as a reviewed claim
ALPS: lidocaine did not beat saline on survival in 3,026 cardiac arrests
In plain words
In the largest trial ever run of drugs given during cardiac arrest, the people who got lidocaine were no more likely to leave hospital alive than the people who got salt water.
What was measured
Survival to hospital discharge in the per-protocol population
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
The Resuscitation Outcomes Consortium randomised adults with non-traumatic out-of-hospital cardiac arrest and shock-refractory ventricular fibrillation or pulseless ventricular tachycardia to amiodarone, lidocaine or saline placebo. In the per-protocol primary analysis population of 3,026 patients — amiodarone 974, lidocaine 993, placebo 1,059 — survival to hospital discharge was 24.4%, 23.7% and 21.0%. Lidocaine versus placebo was a difference of 2.6 percentage points (95% CI -1.0 to 6.3, P=0.16); amiodarone versus placebo 3.2 points (95% CI -0.4 to 7.0, P=0.08); amiodarone versus lidocaine 0.7 points (95% CI -3.2 to 4.7, P=0.70). Neurological outcome at discharge was similar across all three groups. There was heterogeneity by whether the arrest was witnessed (P=0.05), with a significant benefit of active drug over placebo confined to bystander-witnessed arrests.
Written into the record, not signed off as a reviewed claim
ALIVE: amiodarone nearly doubled survival to admission against lidocaine
In plain words
Put head to head in out-of-hospital ventricular fibrillation, lidocaine lost. Twelve percent of the lidocaine group made it to a hospital bed against nearly twenty-three percent of the amiodarone group.
What was measured
Survival to hospital admission
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Dorian and colleagues randomised 347 patients with out-of-hospital ventricular fibrillation resistant to three shocks, intravenous epinephrine and a further shock, in double-blind fashion, to amiodarone plus lidocaine placebo or lidocaine plus amiodarone placebo. Survival to hospital admission, the primary endpoint, was 22.8% of 180 on amiodarone against 12.0% of 167 on lidocaine (P=0.009, odds ratio 2.17, 95% CI 1.21 to 3.83). Among patients reached within the median dispatch-to-drug time of 24 minutes the figures were 27.7% and 15.3% (P=0.05). The trial did not include a placebo arm, so it establishes only that lidocaine is worse than amiodarone, not that either is better than nothing — which is the question ALPS went on to answer in the negative.
Written into the record, not signed off as a reviewed claim
Prophylactic lidocaine after a heart attack cut arrhythmias and may have killed people
In plain words
For years, anyone with a suspected heart attack got lidocaine to prevent a dangerous rhythm. Pooling fourteen trials found it did prevent the rhythm, and that the people given it died slightly more often. The practice was abandoned.
What was measured
That suppressing ventricular fibrillation after myocardial infarction with prophylactic lidocaine saves lives — a surrogate-to-outcome inference the pooled trials pointed against
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
MacMahon, Collins, Peto, Koster and Yusuf pooled 14 randomised trials of prophylactic lidocaine in suspected acute myocardial infarction: 6,961 patients in the intramuscular trials followed for one to four hours and 2,194 in the intravenous trials followed for 24 to 48 hours, with 103 cases of ventricular fibrillation and 137 deaths in total. Allocation to lidocaine reduced the odds of ventricular fibrillation by about one third (95% CI 3% to 56% reduction). Odds of early death were about one third greater on lidocaine, not statistically significant (95% CI 2% reduction to 95% increase). The authors were explicit that the pooled data could not settle whether the drug was helpful or harmful. That an intervention can suppress the surrogate it was aimed at while trending the wrong way on death is the reason this class of reasoning is audited here at all.
Written into the record, not signed off as a reviewed claim
The 5% patch for nerve pain has no good-quality randomised evidence behind it
In plain words
The lidocaine patch is prescribed very widely for nerve pain. A Cochrane review of every double-blind trial found 508 people in total, judged every trial at high risk of bias, and could not pool a single efficacy result.
What was measured
That the 5% lidocaine patch is an established treatment for neuropathic pain — an inference from small cross-over studies the review classed as very low quality throughout
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Derry, Wiffen, Moore and Quinlan reviewed randomised double-blind studies of at least two weeks comparing topical lidocaine with placebo or an active control in chronic neuropathic pain. Twelve studies with 508 participants qualified, across 5% patch, 5% cream, 5% gel and 8% spray, mostly cross-over designs. There was no first-tier and no second-tier evidence by the review's own grading, no pooling of efficacy data was possible, and all studies were judged at high risk of bias because of small size, incomplete outcome assessment or both. Only one multiple-dose study reported the review's primary outcome of at least 30% or 50% pain intensity reduction. The registration evidence itself is thin: the pivotal Rowbotham study was 35 subjects in a four-session cross-over, with each patch session lasting 12 hours.
Written into the record, not signed off as a reviewed claim
Intravenous lidocaine during surgery: a real early effect, ruled out as clinically relevant by 24 hours
In plain words
Running lidocaine into a vein during an operation is promoted as a way to need fewer opioids afterwards. Pooling 68 trials, the early pain effect was too uncertain to call and the later effect was small enough to rule out as meaningful.
What was measured
That perioperative intravenous lidocaine meaningfully improves postoperative pain and recovery — an inference the pooled evidence grades very low quality where the effect is largest and rules out as clinically relevant where the evidence is strongest
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Weibel and colleagues pooled 68 randomised trials with 4,525 participants comparing continuous perioperative intravenous lidocaine with placebo, no treatment or thoracic epidural analgesia. At 1 to 4 hours the standardised mean difference in pain at rest was -0.50 (95% CI -0.72 to -0.28; 29 studies, 1,656 participants) but graded very low quality. At 24 hours the SMD was -0.14 (95% CI -0.25 to -0.04; 33 studies, 1,847 participants) and at 48 hours -0.11 (95% CI -0.25 to 0.04; 24 studies, 1,404 participants), both moderate quality, and both small enough that the review explicitly ruled out a clinically relevant reduction. Opioid sparing was -4.52 mg morphine equivalents overall (95% CI -6.25 to -2.79; 40 studies, 2,201 participants), very low quality. Few studies systematically recorded adverse events at all, so the harm side of the ledger is close to empty.
Written into the record, not signed off as a reviewed claim
Methaemoglobinaemia is a labelled, class-wide harm and not a theoretical one
In plain words
Local anaesthetics can convert haemoglobin into a form that cannot carry oxygen. It is rare, it is on the label, and some people are far more susceptible than others.
What was measured
Reported cases and named susceptibility factors, as carried in the approved label
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The FDA-approved label text held on this record states that cases of methaemoglobinaemia have been reported in association with local anaesthetic use, that all patients are at risk, and that patients with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methaemoglobinaemia, cardiac or pulmonary compromise, infants under six months of age, and those with concurrent exposure to oxidising agents or their metabolites are more susceptible to developing clinical manifestations. Close monitoring is recommended where the drug must be used in those patients. The label is the source; no incidence figure is quoted here because the label does not give one.
Source
FDA-approved US prescribing information for lidocaine hydrochloride injection, Warnings and Precautions
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
How many documents were read
867 documents were read for this substance.
RNAWiki source record
40 of them state the same volumeOfDistribution, and they agree.
RNAWiki source record
Where else this substance is registered
FDA substance identifier (UNII)
98PI200987
CAS registry number
137-58-6
PubChem compound
3676
ChEMBL
CHEMBL79
ChEBI
6456
WHO international nonproprietary name list entry
4202
RxNorm concept
6387
EMA substance identifier
100000091713
European Chemicals Agency number
205-302-8
DrugBank
DB00281
Checks this page had to pass
✓ Passed
Identity resolved
no open identity hold
✓ Passed
No unresolved merge across substance families
no quarantine open
✓ Passed
Every public sentence names a source
The opening statement carries the origin: Written into the record, not signed off.
✗ Not passed
Trial roles classified for highlighted evidence
No registered study is classified as testing this substance.
✓ Passed
No internal keys in reader text
enforced by the copy-contract test over the rendered page
✓ Passed
Safety mode resolved
Suppression classes recorded: S1, S6.
✓ Passed
Canonical metadata present
slug and display name present
What is missing or unclear◇Read from sources, not yet reviewed
How this medicine reached us
Kept near the foot of the page. A historical event moves up only when it changes something about this substance today.
What the approval register records
205 approved applications cover products containing this substance. The earliest was NDA021381, approved 19481119 to DENTSPLY PHARM.
This order is fixed in code and does not count clicks or time on the page.
What is not here
4 questions this page could not answer
These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.
How long anything takes — found nothing in the sources checked.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.
The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
The first amide local anaesthetic: it plugs the inner mouth of the sodium channel so nerves cannot fire, which works so reliably for numbing that no modern trial bothers testing it — and which, given intravenously in cardiac arrest, produced a 23.7% survival to hospital discharge against 21.0% on saline in 3,026 patients, a difference of 2.6 percentage points that did not reach significance.
Recorded evidence blocks (13)
Q2
What did Lidocaine's largest trial (22435 people) and its longest (13 years) measure?
22435 people in Lidocaine's largest registered study, 13 years in its longest registered window, measuring mortality. ClinicalTrials.gov · 2026-09-01
348 na, 270 phase4, 123 phase2, 115 phase3, 54 phase1, 23 early phase1, 15 na or unstated; NCT00540982; 2010-05-20. Last human test completed 2026, NCT07248202.
Interpretation These counts include studies where Lidocaine was a comparison treatment, a background treatment or an exposure in an observational study, and the longest window may be a planned end date. Trial roles have not yet been classified for this record.
Show the evidence
na
348
phase4
270
phase2
123
phase3
115
phase1
54
early phase1
23
2 more recorded rows
na or unstated
15
Last recorded human testNCT07248202
2026-07-25
recorded 2026-09-01 · last checked 2026-09-04
Q3
From mouse to human: where has Lidocaine shown lifespan?
20 recorded entries; human; patch, ophthalmic; also "lidocaine 40mg", "lidocaine patch 5%", "Lidocaine patch 5%"
Show the evidence
human
NCT00146926
lidocaine 40mg
NCT00266214
patch; lidocaine patch 5%
NCT00414453
patch; Lidocaine patch 5%
NCT00533468
Lidocaine Cream 4%
NCT00585325
Instilled 1% Lidocaine
NCT00589979
Lidoderm (Lidocaine 5% Patch)
14 more recorded rows
humanNCT00686231
Lidocaine 20mg
humanNCT00686231
Lidocaine 40mg
humanNCT00769392
Lidocaine 4%
humanNCT00769392
Lidocaine 2% Injectable Solution
humanNCT00835939
25% Dextrose and 1% Lidocaine
humanNCT00903851
Lidocaine Patch 5%
humanNCT00904020
Lidocaine patach 5%
humanNCT00904111
Lidocaine 5% Patch
humanNCT00904462
patch; Lidocaine 5% patch
humanNCT00924963
J-Tip jet injector with 1% buffered lidocaine
humanNCT00924963
4% lidocaine cream
humanNCT00925353
4% lidocaine gel
humanNCT01087489
4% lidocaine
humanNCT01087489
ophthalmic; 3.5% ophthalmic lidocaine gel
recorded 2026-09-01 · last checked 2026-09-04
Q6
More Lidocaine was worse in human: at what point?
U-shaped in human: "The curves of the correlation of the VTh with temperature and the concentration of lidocaine hydrochloride were U-shaped and Λ-shaped respectively." Europe PMC · dose-response search · 2025-11-01
5 recorded sentences naming Lidocaine; U-shaped, dose response, dose-response, biphasic
Show the evidence
U-shapedPMID 35263381
"The curves of the correlation of the VTh with temperature and the concentration of lidocaine hydrochloride were U-shaped and Λ-shaped respectively."
dose responsePMID 41185441
"Several studies have demonstrated the amelioration of refractory migraines with middle meningeal artery (MMA) intra-arterial lidocaine infusion, but the durability beyond 1 month is not well studied, and the angiographic dose response of lidocaine infusion was not previously evaluated."
dose-response
PMID 38591725
"The dose-response curves of guanfacine, dexmedetomidine, and lidocaine were constructed and drug-drug interactions were analyzed by the ED<sub>50</sub> isobologram."
PMID 39187562
"The dose-response of intravenous lidocaine in preventing postoperative vomiting (POV) in children remains unclear."
biphasicPMID 38305616
"Following intravenous administration, plasma lidocaine concentration reached its peak with a time to reach Cmax (Tmax) of 0.05 h and then decreased in a biphasic manner with a very short half-life time (T1/2) of 1.85 h."
recorded 2025-11-01 · last checked 2026-09-04
Q7
Which of amplitude of the vasomotor response to stimuli, area under the curve and assessment of immediate post injection pain severity by did Lidocaine's trials measure?
amplitude of the vasomotor response to stimuli, area under the curve and assessment of immediate post injection pain severity by lead 40 outcome terms across Lidocaine's trials. ClinicalTrials.gov · 2026-09-01
Interpretation resolution of symptoms, pain scores, fatigue scores, severity of airway interruption, quality of operative field and area under the curve follow.
Show the evidence
pain intensity rating
1
amplitude of the vasomotor response to stimuli
1
pain
1
resolution of symptoms
1
pain scores
1
fatigue scores
1
14 more recorded rows
severity of airway interruption
1
quality of operative field
1
area under the curve
1
intensity of pain
1
clinical response rate
1
pain perception
1
extension of florscein paint on the cornea and conjunctiva
1
total sedation time
1
hospital stay
1
treatment success event rates in each group
1
atrial fibrillation
1
mortality
1
average daily pain intensity
1
pain intensity
1
recorded 2026-09-01 · last checked 2026-09-04
Q8
Which of Lidocaine's 91 ongoing trials reports first?
Difference in post-operative pain from admission to the post-anesthesia care unit (PACO) to discharge from the PACO unit to the surgical ward.; Time to complete normal sensation after lidocaine 1%; latest 2031-07
Show the evidence
Trial
NCT03756961
"Effects of an Opioid Free/Sparing Care Pathway for Patients Undergoing Obesity Surgery"; n 220; "Difference in post-operative pain from admission to the post-anesthesia care unit (PACO) to discharge from the PACO unit to the surgical ward."; 2029-12-31
NCT03968822
"Intralipid® 20% for Reversal of Local Anesthetics"; n 18; "Time to complete normal sensation after lidocaine 1%"; 2026-10
NCT04036305
"Local Anesthetic Response in Ehlers-Danlos Syndrome (EDS) and Healthy Volunteers"; n 230; "Delta Pain Scores Lidocaine at 5 min"; 2029-12-31
NCT04048278
"Lidocaine Infusion in Pancreatic Cancer"; n 46; "Specimen outcome measure."; 2028-01-01
NCT04084548
"Perioperative Lidocaine and Ketamine in Abdominal Surgery"; n 420; "Pain scores"; 2025-12
NCT04781673
"Ketamine vs Lidocaine in Traumatic Rib Fractures"; n 74; "Oral Morphine Equivalent - Opioid Usage"; 2026-07
14 further recorded trials
NCT04840511
"The Effect of Perioperative Lidocaine Infusion on Neutrophil Extracellular Trapping"; n 60; "Concentration of citrullinated histone3"; 2027-04-30
NCT05044468
"EXPAREL or Lidocane as Local Anesthetic in Patients Undergoing Pleuroscopy With Pleural Biopsy and Indwelling Pleural Catheter Placement"; n 80; "Global chest pain score"; 2026-05-31
NCT05285566
"Pain Control for Undergoing Costal Cartilage Harvesting"; n 60; "Pain Scores"; 2026-09
NCT05603741
"Local Anesthetic Response in Ehlers-Danlos Syndrome (EDS) and Healthy Volunteers"; n 155; "Delta Pain Scores Lidocaine at 5 min [ Time Frame: 5 minutes post-injection ]"; 2027-06
NCT05737121
"Safety and Efficacy Study of VNX001 Compared to Its Individual Components (Lidocaine and Heparin) or Placebo in Subjects With IC/BPS"; n 120; "Sum of bladder pain intensity differences from baseline to 12 hours post-dose (SPID-12)"; 2026-06
NCT05747469
"Use of Allograft Adipose Matrix for Small Joint Arthritis of the Hand"; n 34; "Range of Motion"; 2027-01-01
NCT05885230
"Efficacy of Ultrasound Guided PIFB Versus Lidocaine Infusion on Postoperative Pain After Sternotomy"; n 138; "Total dose of morphine in the first 24 h postoperatively."; 2027-05
NCT05923086
"Preventing Gastrointestinal Disturbance in Patients After Longitudinal Laparotomy."; n 126; "I-FEED Post Operative Day 3"; 2025-12-31
NCT06045936
"A Study of Contralateral Limb Block"; n 20; "Change in pain"; 2026-12
NCT06223659
"EMLA Topical Cream for Treatment of Pain in Patients Receiving Intra-Dermal Technetium 99 Injections for Lymphoscintigraphy for Skin Cancers"; n 100; "Pain score"; 2026-10-31
NCT06268704
"Particulate vs. Non-Particulate Steroid for Sacroiliac Joint Injection"; n 230; "Pain using Numeric Pain Rating Score"; 2027-05-01
NCT06304779
"The Effect of Continuous Intravenous Infusion of Lidocaine on PPCs and Prognosis in Emergency Surgical Patients With IAI"; n 428; "The incidence of PPCs in patients undergoing emergency laparotomy for IAI with or without continuous 24-hour intravenous lidocaine."; 2027-11-30
NCT06391125
"LIMIT Trial - Lidocaine With Intramuscular Injection of Benzathine Penicillin G for Treponema Pallidum Treatment"; n 48; "Mean Pain Score (0-10) of Benzathine Penicillin G + Lidocaine Injection 10 minutes post injection"; 2025-12
NCT06405776
"Effect of Lidocaine on Postoperative Pain and Long-term Survival in Elderly Patients Undergoing Colorectal Surgery"; n 276; "The incidence of chronic pain at 3 months postoperatively"; 2027-06-01
recorded 2026-09-01 · last checked 2026-09-04
Q9
Which running trial of Lidocaine could settle inflammatory markers?
NCT07432399 measures Change in Serum Cytokine Concentrations (IL-6, IL-8, IL-10, TNF-alpha), reading out 2027-05-01.
2 open trials; n 100; "Effect of Perioperative Lidocaine or High-Dose Dexamethasone on Immune Response in Colon Cancer Surgery (PILDI Study)"
Show the evidence
Trial
NCT07432399
"Effect of Perioperative Lidocaine or High-Dose Dexamethasone on Immune Response in Colon Cancer Surgery (PILDI Study)"; n 100; "Change in Serum Cytokine Concentrations (IL-6, IL-8, IL-10, TNF-alpha)"; 2027-05-01
NCT07347977
"Lidocaine Decreases Postoperative Lung Cancer Reoccurance and Metatasis Risk"; n 1400; "Disease-Free Survival (DFS)"; 2029-12-30
Q10
Which 342 trials of Lidocaine posted no result?
Posted no result
342 of 342 completed trials
Registrations
NCT00554424, NCT03745404, NCT00330941, NCT00108446, NCT00287781 and NCT00600158, and 336 more
Completion dates
oldest 2002-07; newest 2024-09-02
Show the evidence
Trial
NCT00554424
2002-07
NCT03745404
2004-06-30
NCT00330941
2004-12
NCT00108446
2006-03
NCT00287781
2006-04
NCT00600158
2006-07
14 further recorded trials
NCT00441532
2006-08
NCT00258622
2007-02
NCT00236249
2007-05
NCT00058357
2007-07
NCT01439399
2007-07
NCT00456872
2007-09
NCT00594542
2007-09
NCT00656526
2007-12
NCT00986505
2007-12
NCT00508976
2008-04
NCT00521703
2008-04
NCT02287870
2008-06
NCT00681902
2008-07
NCT00991848
2008-09
Q11
At the median, Lidocaine's trials enrolled 70 people — anything larger?
Median enrolment
70
Largest enrolment
22435
Registered trials counted
901
Q12
What do 3152 spontaneous reports say about Lidocaine — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Lidocaine appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 3152 reaction mentions were counted: drug hypersensitivity 484; hypotension 456; toxicity to various agents 392; anaphylactic reaction 379. open-targets-adr · CHEMBL1200409 · 2026-06-24
Show the evidence
drug hypersensitivity
484
hypotension
456
toxicity to various agents
392
anaphylactic reaction
379
anaphylactic shock
289
bradycardia
267
4 more recorded rows
cardiac arrest
254
tachycardia
222
loss of consciousness
219
methaemoglobinaemia
190
recorded 2026-06-24 · last checked 2026-09-04
Q13
Was Lidocaine studied with exercise?
exercise is named in Lidocaine's label sentences: "Therefore, we designed a randomized, double-blind, placebo-controlled clinical trial with a 2-period crossover design to study (1) behavioral incentives to promote exercise and (2) corticosteroid injections to reduce pain and improve function in patients with KOA when compared to lidocaine only." openfda-label+europepmc · 2022-07-27
1 recorded statement; exercise
Show the evidence
exercise
Therefore, we designed a randomized, double-blind, placebo-controlled clinical trial with a 2-period crossover design to study (1) behavioral incentives to promote exercise and (2) corticosteroid injections to reduce pain and improve function in patients with KOA when compared to lidocaine only.
recorded 2022-07-27 · last checked 2026-09-04
Q14
What is recorded about Lidocaine and mTOR?
"Repeated lidocaine exposure promotes A1 astrocyte increase and A2 decrease, inhibiting autophagy via the BDNF/TrkB/mTOR pathway, resulting in toxic protein deposition and Alzheimer's-like cognitive impairment." — where Lidocaine and mTOR appear together. Europe PMC · pathway abstract search · 2026-03-20
"Repeated lidocaine exposure promotes A1 astrocyte increase and A2 decrease, inhibiting autophagy via the BDNF/TrkB/mTOR pathway, resulting in toxic protein deposition and Alzheimer's-like cognitive impairment."
autophagy
PMID 41318982
"Repeated lidocaine exposure promotes A1 astrocyte increase and A2 decrease, inhibiting autophagy via the BDNF/TrkB/mTOR pathway, resulting in toxic protein deposition and Alzheimer's-like cognitive impairment."
PMID 41939844
"This review explores the multifaceted mechanisms by which lidocaine exerts anti-cancer effects, including nuclear regulation, membrane receptor channel inhibition, tumor microenvironment reprogramming, autophagy activation, and synergistic effects when combined with chemotherapy agents."
AMPK
PMID 41599732
"We have also detailed how lidocaine affects critical cellular processes, such as cellular polarization, cytokine production, phagocytosis, and apoptosis, through multiple signaling pathways, including NF-κB, TLR4/p38 MAPK, voltage-sensitive sodium channels, HIF1α, TGF-β/Smad3, AMPK-SOCS3, TBK1-IRF7, and G protein-coupled receptors."
PMID 37914286
"Lidocaine induced neurotoxicity of spinal cord neurons in GK rats via AMPK-mediated mitophagy."
sirtuin
PMID 35212616
"Lidocaine suppressed A431 cell proliferation and cisplatin resistance in a dose- and time-dependent manner <i>via</i> the miR-30c/SIRT1 pathway."
PMID 35212616
"MiR-30c overexpression also suppressed cell proliferation and cisplatin resistance in A431 cells by directly targeting and downregulating SIRT1, thus enhancing the protective effects of lidocaine."
PMID 35212616
"Conversely, SIRT1 upregulation or miR-30c inhibition antagonized the inhibitory effects of lidocaine."
mTORPMID 35464164
"In conclusion, the findings of the present study indicated that lidocaine may inhibit KGN cell proliferation and induce apoptosis by inhibiting the activation of the PI3K/AKT/mTOR signaling pathway."
autophagyPMID 38610945
"Moreover, a combination of lidocaine and SB216763 (a GSK3β inhibitor) suppressed autophagy-related protein expression."
mTORPMID 32905277
"Finally, lidocaine inactivated PI3K/AKT/mTOR pathways via upregulation of miR-145, and it subsequently promoted autophagy of SH-SY5Y cells."
AMPKPMID 34804364
"Taken together, our study demonstrated that lidocaine could inhibit the TLR4/ASK1/TF pathway to alleviate ALI via activating AMPK-SOCS3 axis."
IGF-1PMID 27537755
"Lidocaine inhibited transcripts for IGF-1 and insulin-like growth factor-1 receptor (IGF1R) in fibroblasts from aged donors (IGF-1, log2 fold-change -1.25 [42% of control, 95% CI, 19%-92%, P = .035] and IGF1R, log2 fold-change -1.00 [50% of control, 95% CI, 31%-81%, P = .014])."
NAD+
PMID 1963720
"Lidocaine or aminazine (chlorpromazine) injected to rats or incubated with liver mitochondria prevented NAD-isocitrate dehydrogenase and transhydrogenase activation during the subsequent incubation of mitochondria with cAMP."
PMID 2160290
"Pretreatment of mitochondria with the local anesthetic, lidocaine, prevents the activation of NAD(P)(+)-transhydrogenase and NAD(+)-dependent isocitrate dehydrogenase during subsequent incubation of mitochondria with cAMP."
recorded 2026-03-20 · last checked 2026-09-04
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