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XYLOCAINE is a brand name for Epinephrine (also known as Adrenaline), supplied as a solution. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: XYLOCAINE Parenteral Solutions (lidocaine hydrochloride) are indicated for production of local or regional anesthesia by: • infiltration techniques including percutaneous injection, • peripheral nerve block techniques such as brachial plexus and intercostal blocks, and • central neural techniques including epidural…
Verbatim from this product's HC label. Tap a section to expand.
, Recommended Dose and Dosage Adjustment). Lidocaine should be used with caution in children younger than two years of age as there are insufficient data to support the safety and efficacy of this product in this patient population at this time.
2 Geriatrics Geriatrics (> 65 years of age): Elderly patients should be given reduced doses commensurate with their age and physical condition (see 4 DOSAGE AND ADMINISTRATION, Special Populations). 2 CONTRAINDICATIONS XYLOCAINE Parenteral Solutions are contraindicated in: • Patients with a known history of hypersensitivity to local anesthetics of the amide type or to other components of the solution (see
and 7 WARNINGS AND PRECAUTIONS). , toxic effects) may occur with lidocaine and other local anesthetics or structurally related drugs, and Class I and Class III antiarrhythmic drugs due to additive effects (see
, General). Recommended doses serve only as a guide to the amount of anesthetic required for most routine procedures. 2 Recommended Dose and Dosage Adjustment). The lowest concentration of anesthetic and the lowest dosage needed to provide effective anesthesia should be administered.
The rapid injection of a large volume of local anesthetic solution should be avoided and fractional doses should be used when feasible. The use of lidocaine with epinephrine will prolong the anesthetic action. When XYLOCAINE Parenteral Solutions are used concomitantly with other products containing lidocaine, the total dose contributed by all formulations must be kept in mind.
e. those supplied in multidose vials) should not be used for epidural or spinal anesthesia or for any route of administration that would introduce solution into the cerebrospinal fluid. Local anesthetic solutions containing antimicrobial preservatives solutions should not be administered intra-ocularly or retro-ocularly.
These solutions should not be used in doses greater than 15 mL for other types of blockades (see 2 CONTRAINDICATIONS). XYLOCAINE Parental Solutions, lidocaine hydrochloride / lidocaine hydrochloride and epinephrine bitartrate Page 6 of 35 Special Populations Lidocaine should be used with caution in patients with epilepsy, impaired cardiac conduction, bradycardia, impaired hepatic or renal function and in severe shock (see 7 WARNINGS AND PRECAUTIONS).
Debilitated patients, elderly patients, acutely ill patients, patients with sepsis and children should be given reduced doses commensurate with their age, weight and physical condition (see 7 WARNINGS AND PRECAUTIONS). 2 Recommended Dose and Dosage Adjustment Careful aspiration before and during injection is recommended to prevent intravascular injection.
The main dose should be injected slowly or in incremental doses, while closely observing the patient’s vital functions and maintaining verbal contact.
XYLOCAINE
Parenteral Solutions are contraindicated in: • Patients with a known history of hypersensitivity to local anesthetics of the amide type or to other components of the solution (see 6 DOSAGE FORMS, STRENGTHS, COMPOSITION AND PACKAGING).
• Patients with a known history of hypersensitivity to sodium metabisulfite and/or citric acid (stabilizers used in solutions containing epinephrine). • Patients with a known history of hypersensitivity to methylparaben and/or propylparaben (preservatives used in multidose solutions), or to their metabolite para amino benzoic acid (PABA).
Solutions of lidocaine containing parabens should also be avoided in patients with a history of allergic reactions to ester local anesthetics, which are metabolized to PABA. g. methylparaben) should not be used for epidural or spinal anesthesia, or for any route of administration that would introduce solution into the cerebrospinal fluid because the safety of these agents has not been established with regard to intrathecal injection, either intentional or accidental.
These solutions should not be administered intra-ocularly or retro-ocularly. XYLOCAINE Parenteral Solutions containing antimicrobial preservatives should not be used in doses greater than 15 mL for other types of blockades.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Adults:
Table 1 (Recommended Dosages) summarizes the recommended volumes and concentrations of XYLOCAINE Parenteral Solutions for various types of anesthetic procedures. The dosages suggested in this table are for normal healthy adults and refer to the use of epinephrine-free solutions.
When larger volumes are required, only solutions containing epinephrine should be used except in those cases where vasopressor drugs may be contraindicated.
Children:
In children the dosage should be calculated on a weight basis up to 5 mg/kg. With the addition of epinephrine, up to 7 mg/kg can be used. Individual variations occur. In children with a high body weight a gradual reduction of the dosage is often necessary and should be based on the ideal body weight.
Standard textbooks should be consulted for factors affecting specific block techniques and for individual patient requirements. e. total dose) of local anesthetic used. Thus, an increase in volume and concentration of XYLOCAINE will decrease the time to onset of anesthesia, prolong the duration of anesthesia, provide a greater degree of muscular relaxation and increase the segmental spread of anesthesia.
However, increasing the volume and concentration of XYLOCAINE may result in a more profound fall in blood pressure when used in epidural anesthesia. Although the incidence of side effects with lidocaine is quite low, caution should be exercised when employing large volumes and concentrations since the incidence of side effects is directly proportional to the total dose of local anesthetic agent injected.
The risk of reaching a toxic plasma concentration or inducing a local neural injury must be considered when prolonged blocks and/or repeated administration are employed. In general, complete block of all nerve fibres in large nerves requires the higher concentrations of drug.
, in the relief of labour pain), the lower concentrations are indicated. The volume of drug used will affect the extent of spread of anesthesia. XYLOCAINE Parenteral Solutions, lidocaine hydrochloride / lidocaine hydrochloride and epinephrine bitartrate Page 7 of 35 The duration of effect can be increased by using solutions containing epinephrine (see Table 1).
The risk of epinephrine systemic effects with solutions containing large volumes of epinephrine should be considered. Epidural Anesthesia The lowest dosage that will produce the desired effect should be given. The amount varies with the number of dermatomes to be anesthetized (generally 2-3 mL of the indicated concentration per dermatome).
Solutions with preservatives (methylparaben) should not be used since their safety has not been established.
Caudal and Lumbar Epidural Block Test Dose:
As a precaution against the adverse experience sometimes observed following unintentional penetration of the subarachnoid space, a test dose such as 3-5 mL of 1-2% lidocaine (50- 60 mg) with epinephrine should be administered at least 5 minutes prior to injecting the total volume required for a lumbar or caudal epidural block.
During the administration of a test dose, it is recommended that constant electrocardiographic (ECG) monitoring occur. The test dose should be repeated if the patient is moved in a manner that may have displaced the catheter. Epinephrine, if contained in the test dose (10-15 μg have been suggested), may serve as a warning of unintentional intravascular injection.
If injected into a blood vessel, this amount of epinephrine is likely to […]
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