Lidocaine

Lidocaine – means for local anesthesia.

Pharmacological action

Lidocaine is applied to conduction, infiltration, terminal anesthesia. Drug has mestnoanesteziruyushchy, antiarrhytmic effect.

As anesthetic drug works thanks to oppression of nerve conduction due to blockade of channels of sodium in nerve fibrils and the terminations. Lidocaine considerably surpasses Procainum, its action happens quicker and it is more long – up to 75 min. (in combination with Epinephrinum – more than two hours). Lidocaine at topical administration expands vessels, has no local irritative effect.

The antiarrhytmic effect of drug is caused by ability to increase permeability of membranes for potassium, to block natrium channels, to stabilize membranes of cells.

Lidocaine does not exert significant impact on contractility, conductivity of a myocardium (influences only in high doses).

Level of absorbability of Lidocaine at topical administration depends on a dosage of means and the place of processing (for example, Lidokain on mucous is soaked up better, than on skin).

After intramuscular pricks Lidocaine of the maximum concentration reaches through 5-15min after introduction.

Release form

Spray, Lidocaine in ampoules produce Lidocaine (with solution for pricks).

Indications to Lidocaine use

Pricks apply Lidocaine of 2% to local anesthesia in stomatology, surgery, ophthalmology, otolaryngology, to blockade of neuroplexes, peripheral nerves at patients with pains.

In ampulakh10% apply lidocaine to anesthesia in the form of applications mucous in the LOR-expert, gynecology, pulmonology, gastroenterology, stomatology when carrying out operations, diagnostic manipulations. Apply 10% solution and as antiarrhytmic means.

Lidocaine spray is used in stomatology for removal of milk teeth, a dental calculus, fixing of tooth crowns, by carrying out the other manipulations demanding short anesthesia; in otolaryngology - for a tonsilectomy, truncation of nasal polyps, a partition, anesthesia of process of piercing and washing of a Highmore's bosom.

Spray Lidocaine is effective when carrying out diagnostic manipulations (introduction of the gastroduodenal probe, replacement of a tracheotomic tube) for throat anesthesia.

In gynecology spray is applied during removal of seams, a section of a female crotch at childbirth, carrying out operations on a neck of uterus.

In dermatology spray is used for anesthesia mucous, by skin when holding insignificant surgical procedures.

Contraindications

Lidocaine according to the instruction is contraindicated at an atrioventricular block 2,3y to degree, heart failure 2,3y the degree expressed to bradycardia, hypotension arterial, shock cardiogenic, total cross cordial block, a porphyria, a myasthenia, the expressed renal, hepatic pathologies, a hypovolemia, glaucoma (for eye injections), hypersensitivity, a lactation, pregnancy.

Spray Lidocaine with care is appointed to the weakened, elderly patients, children sick with epilepsy, in depressed cases, at bradycardia, pathology of function of a liver, disturbances of conductivity, pregnancy. During a lactation spray can be applied only in the recommended dosages.

Application instruction of Lidocaine

Before use Lidocaine according to the instruction should be carried out to an allergoprob for detection of possible sensitivity on drug. If there is hypostasis or reddening, it is impossible to apply Lidocaine to anesthesia.

Solution of 2% of Lidocaine (in ampoules) is intended for hypodermic, intramuscular introduction, conduction anesthesia, an instillation to a conjunctival sac, processings of mucous.

The dosage of drug is individual, but in the instruction of Lidocaine such average dosages are specified: for conduction anesthesia use 100-200mg means (no more than 200 mg), for anesthesia of a nose, ears, fingers – 40-60mg drug.

At purpose of pricks Lidocaine, for achievement of the maximum therapeutic effect in addition appoint Epinephrinum (if there are no contraindications).

In ophthalmology about six drops of solution drip, digging in on two drops everyone 30-60sek. Usually 4-6kap. is enough for one eye for anesthesia before carrying out operations, diagnostic manipulations.

For carrying out terminal anesthesia the most admissible dose Lidocaine according to the instruction – 20 ml. A processing time – 15-30min.

When carrying out anesthesia to children, the general dosage should not exceed 3 mg on kg of weight of the child.

Solution of 10% of Lidocaine (in ampoules) is entered intramusculary and applied in the form of applications. The admissible volume of Lidocaine for applications – 2 ml.

For a stop of an arhythmic attack give an intramuscular injection of Lidocaine – 200-400mg. Ate an attack it is not stopped, in three hours do a repeated injection.

At arrhythmia it is possible to enter also 1, 2% solution intravenously struyno – 50-100mg, after that according to the instruction Lidocaine is entered intramusculary.

Applying Lidocaine in ampoules of 2 and 10% it is necessary to control an ECG, to abstain from disinfection of the place of a prick solutions with heavy metals in structure.

At purpose of means in high doses before a prick accept barbiturates.

Spray Lidocaine is applied only locally. Spray drug from small distance directly on the place demanding anesthesia, avoiding hit it in eyes, airways.

At irrigation of an oral cavity because of decrease in sensitivity it is necessary to be careful not to wound language with teeth.

In stomatology, dermatology apply 10% of Lidocaine on 1-3 doses; in otolaryngology, craniofacial surgery – 1-4 doses of 10% of Lidocaine; for carrying out endoscopic inspection – 2-3 doses of 10% of solution; in gynecology – 4-5 doses (at the same time in obstetric practice use to 20 doses 10%rastvora is authorized).

When processing the extensive areas it is possible to use the tampon irrigated with Lidocaine from a barrel.

In this way recommend to use spray when carrying out anesthesia to children (an admissible "children's" dose – 3 mg on weight kg).

Side effects

After drug there can be a weakness, a headache, a nystagmus, fatigue, euphoria, a photophobia, a hearing disorder, numbness of language, lips, drowsiness, nightmares, a diplopia (doubling in eyes), disturbance of a rhythm and conductivity of heart, cross cordial blockade, pressure decline, a stethalgia, paresthesias, paralysis of respiratory muscles, disturbance of sensitivity, a spasm, a tremor.

Lidocaine in high doses can lead to a heart block, a collapse, a cardiac standstill.

Also drug can cause short wind, an apnoea, allergic rhinitis, conjunctivitis, dermatitis, диспноэ, a small tortoiseshell, an acute anaphylaxis, nausea, vomiting, decrease in body temperature, feeling of heat, a fever, numbness of extremities, morbidity in the place where pricks Lidocaine were entered.

Spray can provoke Lidocaine: burning sensation, allergic manifestations, pressure decline, heart attack, depression, drowsiness, uneasiness, loss of consciousness, spasms, paralysis of respiratory tracts, irritability