Which local anesthetic is predominantly used in epidural anesthesia?

Bupivacaine is predominantly used in epidural anesthesia due to its favorable pharmacokinetic properties. This local anesthetic has a long duration of action, which is particularly advantageous for procedures that require extended pain relief, such as labor and postoperative analgesia. Its potency is greater than that of lidocaine, allowing for effective anesthesia with a smaller volume. Furthermore, bupivacaine provides a balanced mix of sensory and motor blockade, which can be adjusted depending on the concentration used, making it suitable for various surgical and obstetric applications.

In contrast, while lidocaine is also used in epidural anesthesia, it is more commonly utilized for shorter procedures due to its shorter duration of action. Cocaine is specialized mainly for topical anesthesia given its vasoconstrictive properties, and is rarely used in epidurals. Articaine, while effective for dental procedures, is not typically employed in epidural anesthesia due to its pharmacokinetic profile and not being as effective as bupivacaine for longer-lasting epidural blocks.