When should doctors use carbocaine with epinephrine and when without epinephrine?

Patient dependent: If the patient has an allergy to xylocaine or lidocaine, Carbocaine is commonly used with or without epinephrine. If a patient has a history of significant cardiovascular disease, Carbocaine without Epinephrine may be the preferred anesthetic. Carbocaine may also be used for patients who do not want a local anesthetic that has a short duration of action, or wears off quickly.