Table 3.
Reptiles: Results of a literature search for use of local anesthetics for local anesthesia in reptiles.
| Agent | Dose | Maximal dose (mg/kg) | Route | Species | Comments |
| Textbooks | |||||
| Bupivacaine | 1–2 mg/kg | 4 | T77 | ND; chelonians58 | Repeat every 4-12 h9,46,57,78 |
| 1077 | LI | ||||
| Lidocaine (0.5% to 2%) | 2–5 mg/kg | 477 | T9,47,75,77 | ND | Infiltrate to effect; often used in conjunction with chemical immobilization;9 repeat every 4–12 h;46,78 used for desensitization of glottis 2–3 min before intubation; good with manual restraint for minor procedures in most reptiles, but additional drugs should be used for venomous snakes and large crocodilians76,77 |
| 10 | LI | ||||
| Lidocaine (0.5% to 2%) | — | 2 | LI | Chelonians | May be used as adjunct to general anesthesia; epithecal anesthesia may be used alone or in conjunction with general anesthesia for surgeries of the cloaca and tail57 |
| 1 mg/kg | — | SI | |||
| Lidocaine 2% | — | — | LI | ND23 American alligators (A. mississippiensis)20 | Line blocks are effective for minor procedures if adequate restraint is provided; digital amputations and a midfemur amputation on alligators performed by using only lidocaine for anesthesia and physical restraint;20 good alternative for general anesthesia for minor procedures23 |
| Procaine 1% | — | — | LI | ND | Good alternative for general anesthesia for minor procedures23 |
| Experimental studies | |||||
| Bupivacaine | 1.15 mg/kg | SI | Red-footed tortoise (C. carbonaria) | Applied 0.2 mL per 5 cm of carapace74 | |
| Lidocaine 2% | — | — | T | Prairie rattlesnakes (C. viridis) | Anesthetized the facial pits: this treatment completely blocked trigeminal responses to cooling or heating of the pits, even with extreme stimuli such as ice or a hot soldering iron; duration of 25 min16 |
| Lidocaine 2% | 1 mg/kg | — | LI | Chelonians | Not sufficient anesthesia for celioscopy when used alone30 |
| Lidocaine 2% | 3 mg/kg | — | SI | D'Orbigny's slider turtle (T. dorbignyi) | Anesthesia and muscle relaxation of the tail, cloaca, and pelvic members; average duration of anesthesia of 82 min; no side effects or significant heart rate change31 |
| Lidocaine 2% | 4 mg/kg | — | SI | Red-eared sliders (T. s. elegans) | Motor block of the tail, cloaca, and hindlimbs; duration of 1 h50 |
| Lidocaine 2% | 4.6 mg/kg | — | SI | Red-footed tortoise (C. carbonaria) | Applied 0.2 mL per 5 cm of carapace74 |
| Case studies | |||||
| EMLA cream (lidocaine-prilocaine) | 1 g/10 cm2 | — | T | Chelonians | Surgical anesthesia was reached within 19.22 ± 4.36 min; full recovery of the tail and hind limb withdrawal reflex and the full response to pinching was recorded at 40.8 ± 7.7 min after application82 |
| Lidocaine 2% | 4–8 mg/kg | — | SI | Red-footed tortoise (G. carbonaria) | Provided an anesthetic period of 45 to 206 min19 |
| Lidocaine 2% | 10 mL | — | LI | Python (P. molurus) | Used to desensitize cloacal mass22 |
| Lidocaine 2% | 5 mg/kg | — | LI | Tegu lizard (T. merianae) | Used at surgical site25 |
| Lidocaine 2% | 0.8 mg/kg | — | SI | Galapagos tortoises (G. nigra) | Allowed phallectomy in conscious tortoises71 |
| Mepivacaine 2% | 1 | 25–29 | LI | Crocodilians | Used as a mandibular nerve block in alligators90 |
| Others | |||||
| Bupivacaine 0.25% | <2 mg/kg | 2 | LI | ND | Useful when the critical nature of a patient precludes general anesthesia51 |
| Bupivacaine | — | — | T | ND | Local anesthetics (lidocaine and bupivacaine) are 1 of the 5 most used analgesic drugs in reptiles in 200467 |
| Lidocaine | LI | ||||
| Cetacaine spray (benzocaine, butamben, tetracaine) | — | — | T | American alligators (A. mississippiensis) | Used at the surgical site63 |
| Lidocaine | — | — | LI | ND | Manual restraint supplemented with local infiltration around the surgical site is satisfactory for minor surgical procedures89 |
| Lidocaine 1% | 4 mL | — | LI | Loggerhead sea turtles (C. caretta) | Used at incision site for laparoscopy43 |
| Lidocaine 1% | 20 μL55 | — | T, LI55 | Female red-sided garter snakes (T. s. parietalis) | Numbed the cloacal region53,54 |
| Lidocaine 1% | 15 | — | LI | Brazilian rattlesnake (C. d. terrificus) | Dose was diluted to a total volume of 1.0 mL in normal saline and divided between 4 injection sites (0.25 mL/site) anterior to the cloaca94 |
| Lidocaine 1% to 2% | — | — | T | ND | Can be used on glottis to help intubation or as a local infiltration for minor procedures; restraint is still required32 |
| LI | |||||
| Lidocaine 1% to 2% | 0.1–0.2 mL | — | LI | Multiple snake species | Combined with general anesthesia (ketamine, hypothermia) for venom gland adenectomy33 |
| Lidocaine 2% | 2–15 mg/kg (0.2–1.0 mL) | — | LI | Tegu lizard (T. merianae) | Used at surgical site4 |
| Lidocaine 2% | — | — | LI | ND | Effective in providing anesthesia for laceration repair, abscess therapy, and other minor procedures5 |
| Lidocaine 2% | <2 mg/kg | 2 mg/kg | LI | ND | Useful when the critical nature of a patient precludes general anesthesia51 |
| Lidocaine 2% | — | — | LI | American alligators (A. mississippiensis) | Use on incision line and to block a heart valve85 |
| Lidocaine 5% | — | — | T | Pond turtle (P. scripta) | Used for postoperative anesthesia of a wound65 |
| Lidocaine 2% + bupivacaine 0.25% | 2 mg/kg + 1 mg/kg | <2 mg/kg | LI | ND | Can help to reduce or negate the need for anesthetic drug in critical patients51 |
| Lidocaine 2% + bupivacaine 0.25% | 2 mg/kg + 1 mg/kg | — | — | ND | Use as needed66 |
| Procaine 1% | — | 250 mg/kg (lethal dose, based on dogs) | LI | ND | Effective in providing anesthesia for laceration repair, abscess therapy, and other minor procedures5 |
| Tetracaine 1% | 20 μL55 | — | T | Female red-sided garter snakes (T. s. parietalis) | Numbed the cloacal region53,54 |