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LIDOCAINE HCL INJ BP is a brand name for Lidocaine (also known as Lignocaine). The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Lidocaine is a local anaesthetic of the amide group. Lidocaine Hydrochloride Injection BP is for use in infiltration anaesthesia, intravenous regional anaesthesia and nerve blocks.
Verbatim from this product's MHRA label. Tap a section to expand.
Posology The dosage should be adjusted according to the response of the patient and the site of administration. The lowest concentration and smallest dose producing the required effect should be given. The following table is intended as a guide to the concentrations, volumes and doses of Lidocaine Hydrochloride Injection BP for various types of anaesthetic procedure in healthy adults.
Elderly or debilitated patients require smaller doses commensurate with age and physical status. For dosage information in other regional local anaesthetic techniques, standard textbooks should be consulted. Type of block Conc. 5 - 30 5 - 300 5 - 300 Peripheral nerves (upper limb) 10 1 – 10 10 - 100 Brachial plexus 10 30 300 50 500 Sciatic 10 - 15 15 - 20 3 in 1 10 - 15 30 Saphenous nerve 10 - 15 10 Inguinal Field Block 5 30 150 Intravenous regional anaesthesia 5 10 - 40 50 - 200 Children: A 1% or 2% solution may be used and the maximum dose should not exceed 5mg/kg (plain) or 7mg/kg [with adrenaline (epinephrine)].
Method of administration The method of administration of lidocaine varies according to the procedure (infiltration anaesthesia, intravenous regional anaesthesia or nerve block).
In common with other local anaesthetics, adverse reactions to lidocaine are rare and are usually the result of raised plasma concentrations due to accidental intravascular injection, excessive dosage or rapid absorption from highly vascular areas, or may result from a hypersensitivity, idiosyncrasy or diminished tolerance on the part of the patient.
9 overdose).
The undesirable effects are defined using the following convention:
Not known (cannot be estimated from the available data).
Blood and Lymphatic System Disorders:
Lidocaine may also result in methaemoglobinaemia.
Immune system disorders:
Hypersensitivity reactions (allergic or anaphylactoid reactions, anaphylactic shock) see also Skin & subcutaneous tissue disorders. Skin testing for allergy to Lidocaine is not considered to be reliable.
Nervous & Psychiatric disorders:
Neurological signs of systemic toxicity include dizziness or light-headedness, nervousness, tremor, circumoral paraesthesia, tongue numbness, drowsiness, convulsions, coma. Nervous system reactions may be excitatory and or depressant.
Signs of CNS stimulation may be brief, or may not occur at all, so that the first signs of toxicity may be confusion and drowsiness, followed by coma and respiratory failure. Neurological complications of spinal anaesthesia include transient neurological symptoms such as pain of the lower back, buttock and legs.
These symptoms usually develop within twenty-four hours of anaesthesia and resolve within a few days. Isolated cases of arachnoiditis or cauda equina syndrome, with persistent paraesthesia, bowel and urinary dysfunction, or lower limb paralysis have been reported following spinal anaesthesia with lidocaine and other similar agents.
Lidocaine should only be used by people with skills in resuscitation. Facilities and equipment for resuscitation should be available when administering local anaesthetics. g. g. hepatic or end renal insufficiency where the metabolites of Lidocaine may accumulate.
The effect of local anaesthetics may be reduced if the injection is made into an inflamed or infected area. Intramuscular Lidocaine may increase creatinine phosphokinase concentrations which can interfere with the diagnosis of acute myocardial infarction.
Lidocaine has been shown to be porphyrinogenic in animals and should be avoided in persons suffering from porphyria. Hypokalaemia, hypoxia and disorder of acid-base balance should be corrected before treatment with intravenous lidocaine begins.
Certain local anaesthetic procedures may be associated with serious adverse reactions, regardless of local anaesthetic drug used. Central nerve blocks may cause cardiovascular depression, especially in the presence of hypovolaemia, and therefore epidural anaesthesia should be used with caution in patients with impaired cardiovascular function.
Epidural anaesthesia may lead to hypotension and bradycardia. This risk can be reduced by preloading the circulation with crystalloidal or colloidal solutions. Hypotension should be treated promptly. 6). Injections in the head and neck region may be made inadvertently into an artery causing cerebral symptoms even at low doses.
Retrobulbar injections may rarely reach the cranial subarachnoid space, causing serious/severe reactions including cardiovascular collapse, apnoea, convulsions and temporary blindness. Retro- and peribulbar injections of local anaesthetics carry a low risk of persistent ocular motor dysfunction.
The primary causes include trauma and/or local toxic effects on muscles and/or nerves. The severity of such tissue reactions is related to the degree of trauma, the concentration of the local anaesthetic and the duration of exposure of the tissue to local anaesthetic.
1. Known hypersensitivity to anaesthetics of the amide type. • Complete heart block • Hypovolaemia Solutions containing adrenaline (epinephrine) should not be used in areas of the body supplied by end arteries or otherwise having a compromised blood supply such as digits, nose, ear or penis.
Solutions containing adrenaline (epinephrine) should not be given intravenously.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
Other brands of Lidocaine in United Kingdom.
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The majority of cases have been associated with hyperbaric concentrations of lidocaine or prolonged spinal infusion.
Eye disorders:
Blurred vision, diplopia and transient amaurosis may be signs of lidocaine toxicity. Bilateral amaurosis may also be a consequence of accidental injection of the optic nerve sheath during ocular procedures. 4 Special warnings and precautions for use).
Ear and labyrinth disorders:
Tinnitus, hyperacusis.
Cardiac and vascular disorders:
Cardiovascular reactions are depressant and may manifest as hypotension, bradycardia, myocardial depression, cardiac arrhythmias and possibly cardiac arrest or circulatory collapse. Hypotension may accompany spinal and epidural anaesthesia.
Isolated cases of bradycardia and cardiac arrest have also been reported.
Respiratory, thoracic or mediastinal disorders:
Dyspnoea, bronchospasm, respiratory depression, respiratory arrest.
Gastrointestinal disorders:
Nausea, vomiting.
Skin & subcutaneous tissue disorders:
Rash, urticaria, angioedema, face oedema. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.
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For this reason, as with all local anaesthetic, the lowest effective concentration and dose of local anaesthetic should be used. Lidocaine Hydrochloride Injection 1% w/v is not recommended in subjects with a shallow anterior chamber or a history of acute narrow angle glaucoma.
Use of Lidocaine Hydrochloride Injection 1% w/v in patients with shallow anterior chamber, a history of acute narrow angle glaucoma and/or insufficient pupil dilation can increase the risk of both iridocele and floppy iris syndrome.
Paediatric population Lidocaine Injection is not recommended for use in neonates. The optimum serum concentration of lidocaine required to avoid toxicity, such as convulsions and cardiac arrhythmias, in this age group is not known. This medicine contains less than 1 mmol sodium (23 mg) per dose, that is to say essentially ‘sodium-free’.