Lidocaine

Lidocaine enter n / a, IM, IV.

Forlocal conduction anesthesia The usual dose is from 5 ml to 10 ml of a 2% solution of lidocaine. Foranesthesia of the brachial and sacral plexus enter 5-10 ml of 2% solution.

Forfinger anesthesia apply from 2 ml to 3 ml of 2% solution. The maximum dose of a 2% Lidocaine solution is 10 ml, this dose should not be re-administered within 24 hours. With local anesthesia, the drug should be injected into highly vascularized tissues carefully to avoid getting into the bloodstream. Before the introduction of lidocaine in high doses, the appointment of barbiturates is recommended.

When applied incardiology administered IV, a single dose of 1-2 mg / kg of body weight and can be up to 100 mg. This dose can be re-administered every 3-4 minutes to a total dose of 300 mg.

IV the drip is administered at a dose of 20-55 mg / kg / min, but not more than 2 mg / min in isotonic or in Ringer's solution. To / in the drip introduction go only after the jet. Duration IV drip is 24-36 hours.

IM is administered in a dose of 2-4 mg / kg of body weight in the gluteal or deltoid muscle at intervals of from 4 hours to 6 hours. A single dose should not exceed 200 mg.

Withmyocardial infarction Before transporting the patient to the hospital, Lidocaine is injected intramuscularly at a dose of 4 mg / kg as a single prophylactic dose (from 200 to 300 mg maximum).

With the help of a soaked tampon, the drug can be applied to large surfaces.
Children under 2 years old It is preferable to use the preparation by applying a tampon, which allows you to avoid the fear that appears during spraying, as well as the burning sensation.

For patients with hepatic and / or heart failure A dose reduction of 40% is recommended.

When using an aerosol cylinder should be kept upright.

During pregnancy and breastfeeding is possible if the expected effect of therapy outweighs the potential risk to the fetus and child.

It is used with caution in patients with impaired liver function, circulatory failure, arterial hypotension, renal insufficiency, epilepsy. In these cases, a reduction in the dose of the drug is required.

With rapid intravenous administration, a sharp decrease in blood pressure and the development of collapse can occur.

In these cases, mezaton, ephedrine and other vasoconstrictor agents are used. Lidocaine solutions should be gently injected into highly vascularized tissues to prevent the drug from getting into the vessel lumen (for example, in the neck area during thyroid surgery) (in such cases, smaller doses of lidocaine are shown.

With extreme caution should use the drug in the presence of injuries of the mucous membranes, with mental retardation, as well as very old and / or weakened patients who are already receiving drugs such as lidocaine for cardiac problems.

In dentistry and orthopedics, the drug should be used only with elastic impression materials.
Avoid contact with the aerosol or contact with eyes; it is important to prevent the aerosol from entering the respiratory tract (risk of aspiration). Applying the drug on the back of the pharynx requires special care. It should be remembered that lidocaine suppresses the pharyngeal reflex and inhibits the cough reflex, which can lead to aspiration, bronchopneumonia.

Use in Pediatrics
It should be borne in mind that in children the swallowing reflex occurs much more frequently than in adults.
Lidocaine aerosol is not recommended for local anesthesia before tonsillectomy and adenotomy inchildren under the age of 8 years.

Influence on ability to drive motor transport and control mechanisms
If the side effects after the use of the drug do not cause discomfort, there are no restrictions for driving vehicles and controlling mechanisms.

Symptoms: initial signs of intoxication - dizziness, nausea, vomiting, euphoria, asthenia, low blood pressure; then - convulsions of the facial muscles of the face, tonic-clonic convulsions of skeletal muscles, psychomotor agitation, bradycardia, collapse; when used in childbirth in a newborn - bradycardia, depression of the respiratory center, respiratory arrest.

Treatment: when the first signs of intoxication appear, the administration is stopped, the patient is transferred to the horizontal position; prescribe inhalation of oxygen. When convulsions - intravenous 10 mg of diazepam. In bradycardia, m-anticholinergics (atropine), vasoconstrictors (norepinephrine, phenylephrine). Intubation, mechanical ventilation and resuscitation are possible. Dialysis is ineffective.