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15.2 Local anaesthesia

Chloroprocaine 1% (spinal anaesthesia for short procedures < 40 mins)
Cocaine paste 10%
Cocaine paste 10% and adrenaline 0.05% nasal spray
Cocaine 10% nasal spray
Lidocaine hydrochloride injection, gel, ointment, spray, topical solution
Lidocaine with epinephrine (adrenaline) 1 in 200,000 injection 20ml vial, 1 in 80,000 2ml cartridge
Xylocaine 2% in 80 000 lastic cartridge
Bupivacaine hydrochloride injection
Prilocaine hydrochloride injection
Prilocaine with felypressin
Prilocaine 2% ('heavy') (Prilotekal®) for spinal anaesthesia only - see note
Procaine hydrochloride injection
Ametop gel
Emla cream (for GUM)
Lidocaine/adrenaline/tetracaine (LAT gel) for surface lacerations of face and scalp (paediatric ED only)
Instillagel gel


1. Levobupivacaine for caudal analgesia (paediatric theatres): 2.5mg/ml (0.25%).

For loading dose for epidural anaesthesia (paediatric theatres): 2.5mg/ml (0.25%).

For epidural top ups (obstetrics): 2.5mg/ml (0.25%); 5mg/ml (0.5%).

For use in carotid artery surgery: 5mg/ml (0.5%). 

2. Heavy prilocaine is available as an alternative to heavy bupivacaine for spinal anaesthesia - in day case patients - where the shorter duration of action is justified despite the higher cost (approx. £8 extra per patient).

For link to BNF section: 15.2 Local anaesthesia