Lidocaine: purpose and features of application. Lidocaine and its painkiller action Maximum dose of lidocaine

The date: 04.07.2020

Lidocaine is used as a medicine for local anesthesia. It is widely used in dentistry. It is also used in cardiac therapy as an antiarrhythmic drug.

Apply Lidocaine can be used only by appointment of a doctor, because there are many risk groups, on the health of which can affect the use of the components of the drug. To prevent the occurrence of side effects, you should carefully adhere to the instructions for the use of the drug.

Instructions for applying Lidocaine

Lidocaine enjoys such popular medicine in the world due to longer and strong action than the same novocaine.

First of all before taking this kind of drug you need to do allergocking. If the sensitivity to the drug is strongly increased - the injection is strictly prohibited.

Composition

The main substance of the drug is lidocaine hydrochloride. It is given in the form of lidocaine hydrochloride monohydrate. The auxiliary substance is sodium chloride. For parenteral forms, its amount is 12 mg. In a solution of water d / and - about 2 ml.

Form release

Lidocaine is available in form Solution for injection and spray. Liquid without color or color is absent partially. There is no smell. In 1 ampoule is 1 mg of active drug. 2 ml ampoules are packaged in cardboard boxes (cells).

Pharmacological properties

Lidocaine I use as as local anesthesia and antiarrhythmic drug In cardiovascular medicine.

In the role of anesthetizing means, Lidocaine shows great efficiency than plotting and novocaine. Its action is longer - approximately 1 hour and 15 minutes. This time can be extended to two hours, if applied in combination with epinephrine.

The components of this drug have depressing effect on the conductivity of nerve endings. This is due to the blocking of sodium channels in the nerves. If applied with local anesthesia, lidocaine has no irritable effect. Its distinctive quality is the expansion of vessels.

Antiarrhythmic effect It is possible due to the same blocking of calcium channels, the ability to increase the permeability of membranes for potassium and normalization of the cell membrane structure.

Lidocaine in normal doses does not affect the contraction of myocardium. It becomes possible only in large doses.

Another feature of Lidocaine is its ability Better and faster absorbed precisely on mucous membranes. The level of absorption of the drug in other tissues depends on the dosage and place of use.

During intramuscular injections Lidocaine begins its action for 5-15 minutes. Then the maximum action comes.

Indications for use

Lidocaine injections in 2% ampoules Apply to those patients, medical procedures that may be accompanied by painful sensations. For local anesthesia, in such cases, they are used in the extensive number of clinical departments: in dentistry, ophthalmology, surgery, otolaryngology, etc. there is a blocking of nerve plexuses and centers with peripheral nerves.

10% solution of this drug is taken as an antiarrhythmic drug. It is also used for anesthetic action in surgery, pulmonology, surgery, LOR-Practice.

Lidocaine in the form of spray Actively used in dental practice. It is required for short-term manipulations for which local anesthesia is required. It may be the removal of dairy teeth, fixing the crown of the tooth or breaking the dental stone.

Also lidocaine spray is actively used in otolaryngology. There he will also start as an anesthetic. It is used when cutting out the nasal polyps, tonsilectomy, for reading the gaymorette sinuses, piercing process, etc. It is widely used for the anesthesia of the pharynx during a different kind of manipulation.

Application of lidocaine spray in women's gynecology also It is often found. This happens during the overlapping and removal of seams, in case of dissection during childbirth, if operations are carried out on the cervix. To carry out minor surgical manipulations of lidocaine in the form of spray use and in dermatology. Oh read here.

Contraindications

Lidocaine is contraindicated in patients in such cases:

If the patient has a blockade of an atrioventricular 2nd, 3rd degree;
Heart failure;
Arterial hypotension (reduced pressure);
Pronounced bradycardia;
Cardiogenic shock;
In the presence of a full transverse cardiac blockade;
Porphyria in the patient;
The presence of liver pathologies;
Hypersensitivity to the components of the drug;
Miasti;
Eye injection in glaucoma should not be carried out;
Hypivulium;
During lactation;
During pregnancy;
The presence of kidney pathologies.

Also lidocaine in the form of spray with great caution are prescribed:

Children and patients in old age;
Patients with severely weakened organism;
Patients with epilepsy;
Patients in a shock state;
If there is bradycardia;
With improper conductivity;
Patients with liver pathologies;
During pregnancy.

During breastfeeding period, the spray can be used only in small doses.

Side Effects and Overdose

In case of side effects in a patient, such deviations can be observed:

In some cases, the use of lidocaine can cause blockade and stop the heart. This occurs during the concentration in the body of large doses of the drug.

Also among the side effects can be seen:

The appearance of conjunctivitis;
The presence of strong shortness of breath;
Apnea;
May cause allergic rhinitis;
There is a decrease in body temperature;
Anaphylactic shock in patients;
Dermatitis;
Urticule;
A person often throws in the heat;
Numbness of the limbs;
Chills;
The pain in the place where the injection was introduced.

If the lidocaine spray was used, then the side effects of it can be:

Manifestations of allergies;
Burning;
A slight decrease in blood pressure;
Drowsiness;
Alarm state;
The emergence of depression;
Myocardial infarction;
Spasms in the limbs;
The possibility of losing consciousness at any time;
Constant irritability;
There is the possibility of paralysis of the respiratory tract.

Lidocaine overdose symptoms are developing gradually.

You can list such stages of their development:

First of all, paresthesia can develop in the area of \u200b\u200bthe mouth, numbness, the patient can feel noise in the ears of different strength, may be observed dizziness;
Violation of the quality of vision and tremor muscles may accompany the stronger toxicity of the body;
The following follows convulsions - They cannot be confused with neurotic seizures;
Loss of consciousness preceded the emergence of stronger seizures that can reach from a few seconds to a couple of minutes;
Due to increased muscle activity and high respiratory frequency convulsions can lead to the fastest development of hypercaps and hypoxia;
The most difficult cases can cause apnea;
Symptoms lead to violations in the work of the cardiovascular system;
In cases that carry the greatest danger to human life, diseases such as arterial hypotension, bradycardia and heart arrhythmia can develop, stop the heart.

Consequences can be very seriousTherefore, the use of lidocaine should occur in strict accordance with the instructions and testimony of doctors. Seeing the suspicious reactions of the body that may be related to treatment, it is necessary to apply to the attending physician. So you can avoid more dangerous manifestations of adverse reactions.

When the first symptoms of overdose appear Lidocaine the use of the drug should be immediately stopped. Cramps and problems with the central nervous system that arose due to the use of this drug, even require a surgical operation. Moreover, dialysis during the overdose of the lidocaine almost does not have effectiveness.

Method of application, dose

Dosage of the drug Lidocaine is applied individually For each patient. First, this factor has a patient's reaction to the components of the drug. Secondly, a place to use. On average, dosage at 100-200 milligrams is suitable for using the drug for local anesthesia. In order to paink up the ears, the cloth or the nose is enough 30-40 mg of lidocaine.

Mainly use the minimum dose that can give a positive and strongest effect. For adults, she should not exceed 300 milligrams.

The solution is bred directly before use. Its concentration and the number directly depend on the area of \u200b\u200bthat area to be anesthetic. If a solution is needed with a weak concentration, then it is done using a saline solution.

For children and older people The dose should be much smaller. This helps to reduce the load on the body.

For adults and teenagers The dose can not exceed 5 milligrams per 1 kilogram of weight. Maximum allowed to introduce up to 300 milligrams of lidocaine.

Medical research on the use of lidocaine in children under 1 Not conducted. Therefore, the use of this drug is not recommended at that age. Also limited dosage medication for children from 1 to 12 years. The dose of the drug should not be above 5 milligrams per 1 kilogram of weight.

Pregnancy and lactation: Application during this period

Experts recommend applying lidocaine during pregnancy and breastfeeding, only if the benefit from it can block the damage. It should only strictly adhere to the necessary dosage, in no case is it not exceeded. In obstetric practice it does not apply Lidocaine in cases of bleeding in history and different types of complications.

When applied in pregnant women And women of the childbearing age of special violations were not observed. The reproductive function was not broken, and the fetal defects were also observed. But the dosage of the drug occurs only in the form of 1% solution.

During clinical research on animals, there were no harmful manifestations. Impact on the fruit is limited.

The decision on whether it is possible to take lidocaine during lactation can take Only attending physician. But it can be noted that the number of components of this drug that penetrate into breast milk is very insignificant. Therefore, it cannot, it cannot cause a toxic influence on the child.

Interaction with other drugs

If lidocaine is used with such drugs as propranol or cimetidinethen its quantity needs to be reduced. This is due to the fact that substances of these drugs increase the toxicity of lidocaine. Also promotes its concentration Ranitidine.

Antiretroviral tools In the same way, its serum cluster in the patient's body increases. But the simultaneous use of diuretics reduces the action of lidocaine.

The simultaneous use of lidocaine and such drugs should be avoided as hinpristin and Dalfostein. Their simultaneous concentration increases the risks of the start of arrhythmia.

If, together with the drug, take the thoroughbating agents, then you can increase the time of the lidocaine.

special instructions

The use of the drug Lidocaine should be engaged exclusively by specialists who have resuscitation skills. Serious observation should be conducted for patients who simultaneously accept amiodar or other medicines of this type. It must be done to avoid heart reactions to the drug.

Local anesthesia can lead to the development of the arterial hypotension. Also may arise Bradycardia. Reduced pressure must be immediately stopped. To prevent these symptoms, it is necessary to make the injection of crystalloid and colloidal solutions before applying the drug. They will not allow the development of these side effects.

The cost of lidocaine

The cost of the drug depends on the form of release (spray or ampoule) and the place of sale. The price of lidocaine also depends on the manufacturer's company. On average, the price of Lidocaine is about 300-400 rubles for packaging.

Lidocaine is a local anesthetic.

Release form and composition

Lidocaine dosage forms:

The injection solution (1% is 2 ml in ampoules, 10 ampoules with an ampumen knife in a cardboard pack; 3.5 ml in ampoules, 10 ampoules with an ampumen knife in a cardboard pack; 5 ml in ampoules, 10 ampoules with an ampumen knife in a cardboard pack; 5 ml in ampoules, 5 ampoules in contour cellular packs, 1 or 2 packs with an ampumen knife in a cardboard pack; 10 ml in ampoules, 10 ampoules with an ampumen knife in a cardboard pack; by 10 ml in ampoules, 10 ampoules in contour cellular packs, 1 pack with an ampumen knife in a cardboard pack; 10 ml in ampoules, 5 ampoules in contour cellular packs, 1 or 2 packs with an ampumen knife in a cardboard pack; 2 % - 2 ml in ampoules, 5 ampoules in contour cellular packs, 20 packs in a cardboard box; 2 ml in ampoules, 10 ampoules with an ampumen knife in a cardboard pack; 2 ml in ampoules, 5 ampoules in contour packages (pallets), 1 or 2 pallet with an ampumen knife in a cardboard pack; 2 ml in ampoules, 10 ampoules in contour cells Packages, 1 or 2 packs with an ampumen knife in a cardboard pack; 5 ml in ampoules, 10 ampoules with an ampumen knife in a cardboard pack; 5 ml in ampoules, 5 ampoules in contour cellular packages, 1 or 2 packs with an ampumen knife in a cardboard pack; 10 ml in ampoules, 10 ampoules with an ampumen knife in a cardboard pack; 10 ml in ampoules, 5 ampoules in contour cellular packs, 1 or 2 packs with an ampumen knife in a cardboard pack; 10% - 2 ml in ampoules, 10 ampoules with an ampumen knife in the package; 2 ml in ampoules, 5 or 10 ampoules in contour cellular packs, 1 or 2 packs with an ampumen knife in a cardboard pack; 2 ml in ampoules, 5 ampoules in contour packages (pallets), 1 or 2 pallet with an ampumen knife in a cardboard pack);
Eye drops (2% - 1.5 or 2.5 ml in dropper tubes, 1, 2, 4, 5, or 10 tubes in a cardboard pack; 5 or 10 ml in dropper bottles, 1 or 2 bottles in a cardboard pack; 5 ml in polyethylene flocks-droppers, 1 or 50 bottles in a cardboard pack; 4% - 1.3 or 1.5 ml in tube-droppers, 5 tubes in a cardboard pack);
Gel for local application is 5% (15 or 30 g in aluminum tubes, in a cardboard pack of 1 tube; 25 g of dark glass cans, in a cardboard pack 1 bank);
The spray for the local application is 10% dosage (38 g in bottles of dark glass with a sprayer, 1 vial in a cardboard pack; 38 g in aerosol or polypropylene bottles with a dental and spray gun for oral applications).

The active ingredient of the drug - lidocaine is anhydrous hydrochloride. Its content:

1 ml of solution - 10, 20 or 100 mg;
1 ml of eye drops - 20 or 40 mg;
1 g of gel - 50 mg;
1 dose of spray - 4.8 mg.

Indications for use

For a solution:

Infiltration, spinal, epidural and conductor anesthesia;
Terminal anesthesia (including in ophthalmology);
Ventricular arrhythmias caused by glycoside intoxication;
The relief and prevention of repeated paroxysms of ventricular tachycardia, re-fibrillation of ventricles with acute coronary syndrome (usually within 12-24 hours).

For eye drops - local anesthesia during the following procedures:

Contact methods of research (diagnostic corneal scrapets, gonoscopy, tonometry);
Preparation for ophthalmological operations;
Brief operational interventions on the cornea and conjunctiva, including the extraction of suture material or foreign bodies.

For gel - surface anesthesia of mucous membranes:

Dentistry: removal of movable milk teeth and tartar, overlaying seams on the mucous membrane, pain relief region of the injection area in front of local anesthesia;
Otaginolaryngology: electrocoagulation, operation on the nasal partition, etc.;
Obstetrics and gynecology: removal of seams, cutting processing and episotomy, intervention on the vagina and cervix, etc.;
Instrumental and endoscopic research (intubation, rectoscopy, probe administration) and X-ray examination (to eliminate pharyngeal reflex and nausea).

Additionally for gel:

Surface anesthesia of the skin with small surgical interventions;
Anesthesia in burns (including solar), small wounds and scratches, contact dermatitis, insect bite.

For spray:

Local anesthesia of the mucous membranes in dental practice and oral surgery: removal of movable milk teeth and bone fragments, opening of surface abscesses, the imposition of seams on the mystery wounds, fixation of the crown or bridge-like prosthesis (only with the use of elastic impudent material), excision of surface benign mucous membranes oral cavity shells, manual or instrumental excision of an increased nipple language, a decrease or suppression of increased pharyngeal reflex in the preparation of a patient to a radiographic study, in children - phrenhooloectomy, opening the cyst of the salivary glands;
ENT Practice: anesthesia before washing sinuses, septomy, electrocoagulation, resection of nasal polyps, tonsillecthectomy for anesthesia of the injection site and reduce pharyngeal reflex (with the exception of adenenectomy and tonsillectomy in children under 8 years old), as well as before puncture of the maxillary sinus or opening peritonzillary abscess (as an additional anesthesia);
Endoscopy and instrumental inspections: anesthesia before administration through the mouth or nose of various probes, in front of rectoscopy and in case of replacing catheters;
Obstetrics and gynecology: the anesthesia of the crotch for the treatment and / or execution of episiotomy, when applying seams in abscesses, for excision and in the treatment of a gap of a virgin splava, an operating field in vaginal surgery and cervical surgery;
Dermatology: anesthesia of mucous membranes during small surgical interventions.

Contraindications

All dosage forms of lidocaine are not prescribed with increased sensitivity to the components of the drug.

There are also additional contraindications.

For a solution:

Cardiogenic shock;
Acute and chronic heart failure (III-IV FC);
Pronounced decrease in blood pressure;
Synoyatrial blockade;
WPW syndrome;
AV blockade II-III degree (except for cases when a probe was introduced for stimulation of ventricles);
Adams-Stokes syndrome;
Pronounced bradycardia;
Violation of intraventricular conductivity;
Pregnancy;
Lactation period;
Retrobulbar administration of patients with glaucoma.

For spray:

A significant reduction in the function of the left ventricle;
Pronounced bradycardia;
Morgali-Adams - Stokes syndrome;
Sinus node weakness syndrome;
AV blockade II and III degree and disorders of intraventricular conductivity (except when a probe is introduced for stimulation of ventricles);
Cardiogenic shock;
Anamnesis instructions for convulsions related to the use of the drug;
Use in the dentistry of plaster as an impression material.

With caution injection of lidocaine are made in the following cases:

Reduced hepatic blood flow;
Heavy hepatic / renal failure;
Arterial hypotension, hypovolemia;
Sinus bradycardia;
AV-block I degree;
Chronic heart failure II-III;
Epileptiform convulsions (including history);
Severe miastic;
Age up to 18 years;
Weakened state and age over 65 years;
Increased sensitivity to other amide places in history.

Eye drops with caution are prescribed to children, pregnant and nursing women.

Spray with caution should be applied in the following cases:

Violation of the liver function;
Blood circulation failure;
Arterial hypotension;
Renal failure;
Epilepsy;
Injuries of mucous membranes;
Mental retardation;
Pregnancy;
Lactation;

An elderly age and a weakened state in patients who already receive a drug with a similar effect on the cardiological disease.

Gel with caution apply in such cases:

Hemorrhoidal bleeding (in the case of a rectal study);
Leather injury or mucous membrane in the application;
Local infection in the field of application;
Accompanying acute diseases;
Youth Children and Elderly Age;
Loose state;
Pregnancy;
Lactation.

Method of application and dosage

The method of application and dose of solution Lidocaine is determined individually depending on the readings:

Infiltration anesthesia: subcutaneously, intradermode, intramuscularly; Apply a solution of 5 mg / ml, the maximum allowable dose is 400 mg;
Blockade of nerve plexus and peripheral nerves: perinethuous 10-20 ml of 1% solution or 5-10 ml of 2% solution, but not more than 400 mg;
Conductive anesthesia: perioreral 1% or 2% solution, maximum dose - 300 mg;
Epidural anesthesia: Epidural 1% or 2% solution, maximum dose - 300 mg;
Spinal anesthesia: subarachnoid 3-4 ml (60-80 mg) 2% solution;
In ophthalmology: 2 drops 2% of the solution are buried in a conjunctival bag 2-3 times at an interval of 30-60 seconds immediately before studying or surgery.

If you need to elongate the action of lidocaine, a 0.1% solution of adrenaline is added to it (1 drop for every 5-10 ml of lidocaine solution, but not more than 5 drops on the entire volume of the solution).

Elderly people, patients with reduced hepatic blood flow (chronic heart failure) and liver diseases (hepatitis, cirrhosis) It is recommended to reduce the dose by 40-50%

When applying lidocaine, the solution is administered intravenously as an antiarrhythmic agent. For these purposes, a 10% solution (100 mg / ml) is used after dilution: 25 ml in 100 ml of saline (the concentration of lidocaine should be 20 mg / ml). The resulting solution is administered as a load dose. The initial dose is 1 mg / kg, it is administered at a speed of 25-50 mg / minute, for 2-4 minutes, after which the constant infusion is immediately connected at a speed of 1-4 mg / minute. 10-20 minutes after the administration of the first dose, there is a decrease in the concentration of lidocaine in the blood plasma, which may require a repeated bolus administration (simultaneously with constant infusion) in a dose of 1/2-1 / 3 from the initial load, with intervals 8 -10 minutes. Within 1 hour, no more than 300 mg of lidocaine can be introduced, the maximum permissible daily dose - 2000 mg.

Intravenous infusion is usually carried out within 12-24 hours under constant monitoring of the electrocardiogram. Then the infusion is stopped to assess the patient's condition and the need to change antiarrhythmic therapy.

Elderly people, patients with impaired liver function (hepatitis, cirrhosis) and heart failure, the dose and the rate of administration of the drug are reduced by 25-50%.

Eye drops Lidocaine drip into a conjunctival bag of 1-2 drops 3 times with an interval of 30-60 seconds immediately before surgery or research.

Spray Lidocaine spray on the mucous membranes while holding the balloon in a vertical position. Doses of the doctor determines individually depending on the testimony and area of \u200b\u200bthe anesthetic surface.

Approximate number of spraying (doses) at various testimony:

Dermatology - 1-3;
Dentistry - 1-3;
Oral surgery and otorhinolaryngology - 1-4;
Endoscopy - 2-3;
Gynecology - 4-5;
Obstetrics - 15-20.

For children under 2 years of age, it is preferable to apply the drug by applying a cotton swab: this avoids the feeling of burning and reduces the feeling of fear of a child.

Patients with hepatic or / heart failure dose are reduced by 40%.

Lidocaine gel is designed for local applications.

In dentistry:

In front of infiltration anesthesia - applied to the mucous membrane with an interval of 2-3 minutes in the region of subsequent infiltration anesthesia;
Dental removal - rubbed into the gum edge and neck cervix for 2-3 minutes before the procedure;
After the cuzhetta or removal of the dental stone - they are applied on the gauge pocket and fix;
The treatment of AFT and erosion is applied several times a day on the mucous membrane.

For anesthesia of the mucous membrane of the larynx, trachea, the esophagus lubricate the surface of the tools intended for the study. For surface anesthesia of the mucous membrane of the mouth, the gel is applied with a sterile glass wand or processed the mucous sterile cotton swab, moistened in the gel. Dose of the drug - 200-2000 mg. With insufficient severity of anesthetic effect after 2-3 minutes, the processing is repeated. For 12 hours, adults can be applied to a dose of no more than 300 mg of lidocaine (6 g of gel).

In other cases, the dose is established individually.

Children are prescribed to 4.5 mg / kg.

Side effects

When applying a solution of lidocaine:

Central nervous system: euphoria, drowsiness, headache, dizziness, general weakness, disorientation, diplopia, light-friendly, nastagm, noise in ears, confusion or loss of consciousness, tremor, paresthesia, trisms of mimic muscles, anxiety, neurotic reactions, convulsions;
Cardiovascular system: reduced blood pressure, chest pain, peripheral vasodulatation, collapse, bradycardia (up to a heart stop);
Digestive system: nausea, vomiting;
Allergic reactions: rash, itching, urticaria, anaphylactic shock, angioedema swelling;
Others: feeling of cold or heat, resistant anesthesia, methemoglobinemia, hypothermia, erectile dysfunction.

When using eye drops, irritation of conjunctivations, local allergic reactions, with long-term use - corneal epithelials are possible.

When applying gel and spray:

Local reactions: fast-burning sensation of light burning (passes for 1 minute as the anesthetic effect develops);
Cardiovascular system: extremely rarely arterial hypotension, bradycardia;
Central nervous system: extremely rare - anxiety, dizziness, headache, violation, tremor, convulsions, depression;
Allergic reactions: extremely rarely - itching, skin rash, anaphylactic shock.

special instructions

Special caution must be observed when conducting local anesthesia tissues with high vascularization. To avoid intravascular administration of the drug, it is recommended to conduct an aspiration sample.

Patients receiving monoaminoxidase inhibitors (MAO) must be canceled by their at least 10 days before the scheduled application of lidocaine.

During the period of treatment with lidocaine in the form of an injection solution, caution must be taken when driving and performing work, requiring the speed of reactions and concentration of attention.

When applied spray and gel, contact with eyes and getting inside, aerosol - in the respiratory tract. Especially carefully apply the drug on the rear wall of the pharynx.

Medicinal interaction

It should be borne in mind that Lidocaine:

Enhances muscle relaxation of stripping drugs;
Reduces the cardiotonic effect of digitoxine;
Reduces the effect of antimone-bearers;
Strengthens and lengthens the action of muscle relaxants.

Cimetidine and beta-adrenoblockers increase the risk of developing toxic effects of lidocaine. Verapamil, Amiodaron, County and Aimalin strengthen its negative inotropic effect. Inductors of microsomal liver enzymes (rifampicin, phenytoin, barbiturates) reduce its effectiveness. Ethanol enhances its oppressive effect on breathing. Adrenaline and other alpha adrenomimetics will prolong its effect.

With the simultaneous use of vasoconstrictors (phenylephrine, metoxamine, epinephrine), the anesthetic effect of lidocaine can cause an increase in blood pressure and tachycardia.

Mekamylamine, Guanethidine, Trimetafan, Guadarl raise the risk of a pronounced reduction in blood pressure and development of bradycardia.

When combined with procanamide, hallucinations and excitation of the central nervous system are possible.

With caution Lidocaine should be used in combination with phenythine and definition, because There is a possibility to reduce its resorbative action, as well as the development of an undesirable cardiodepressive effect.

MAO inhibitors can enhance the anesthetic effect of lidocaine and contribute to a decrease in blood pressure. Patients receiving Mao inhibitors are contraindicated with parenteral use of lidocaine.

With the combined application of lidocaine with thiopental sodium, hexenal, opioid analgesics, sedative or sleeping agents, it is possible to strengthen the oppressive effect on the breath and the central nervous system.

In the case of the use of lidocaine, simultaneously with polymicysine B, it is necessary to monitor the patient's breathing function.

With intravenous administration of lidocaine, patients receiving cimetidine are possible such unwanted effects such as drowsiness, paresthesia, state of stunning and bradycardia. If you need to use a similar combination, it is necessary to reduce the dose of lidocaine.

In the case of the use of lidocaine simultaneously with antiarrhythmic drugs of class I A (dyspeciamide, procanamide, quinidine), the Qt interval is elongated, in rare cases, the fibrillation of ventricles or AV blockade is possible.

Lidocaine can enhance the effect of drugs that cause the blockade of neuromuscular transmission.

Rating: 4.9 - 23 Votes

Composition

active substance: lidocaine;

1 ml of solution contains lidocaine of 100 mg hydrochloride; excipients: sodium hydroxide, water for injection.

Pharmacotherapeutic group

Antiarrhythmic drugs IB class. Lidocaine.

PBX code C01B B01.

Indications

Prevention and treatment of ventricular arrhythmias, especially in the acute period of myocardial infarction.

Contraindications

Increased sensitivity to the components of the drug / other amide plastic resources, the presence of a history of epileptiform seizures on lidocaine, severe bradycardia, severe arterial hypotension, cardiogenic shock, severe forms of chronic heart failure (P-C degree), sinus node weakness syndrome, Wolf Parkinson syndrome - Aite, Adams-Stokes syndrome, atrioventricular (AV) blockade II and III degree, hypovolemia, severe liver / kidney function, porphyria, myasthenia.

Method of application and dose

Before intravenous administration, a solution of lidocaine 100 mg / ml is bred by a sterile isotonic sodium solution to a concentration of 20 mg / ml. Intravenous infusion is carried out at a rate of 1.5-4 mg / min with constant ECG monitoring. Due to the rapid distribution of lidocaine in the tissue 10-20 minutes after the start of the administration of the first dose of the drug, a decrease in the concentration of lidocaine in the blood is reduced, which can lead to the resumption of arrhythmia (usually by 30 minutes of infusion) and requires a continuing infusion of an additional bolus administration of the divorced solution of the drug in Dose 25-50 mg (1.25-2.5 ml).

Infusion is carried out within 24-36 hours (before improving the patient's condition); The duration of infusion depends on the patient's condition and the results of the use of the drug. Under the introduction for more than 24 hours it is necessary to reduce the rate of infusion.

Side reactioniI

From the nervous system: excitation of the central nervous system (when used in high doses), anxiety, headache, dizziness, sleep disorder, confusion, drowsiness, loss of consciousness, coma, sensitivity impairment, motor block; In patients with increased sensitivity - euphoria, tremor, triumism, motor anxiety, paresthesia, convulsions. The first adverse reactions from the nervous system are developing at the concentration of lidocaine in blood 5.6 μg / ml.

From the authorities of the vision: Nistagm, reversible blindness, diplopia, flickering "flies" before your eyes, light-free, conjunctivitis.

From the side of the hearing organs: Hearing violations, noise in the ears, hyperactus.

From sidecardiovascular Systems: When applied in high doses - arrhythmia, bradycardia, slowdown in the conductivity of the heart, transverse blockade of the heart, stopping cardiac activity, peripheral vasodulation, collapse; Very rarely - tachycardia, increase / decrease in blood pressure, heart pain. The first adverse reactions from the cardiovascular system are developing at a concentration of lidocaine in 20 μg / ml.

From the digestive system: nausea, vomiting.

From the respiratory system: Dyspnea, rhinitis, tachipne, oppression or stop breathing.

Blood diseases and lymphatic system: Rarely - methemoglobinemia (at any age, the most dangerous in children in the neonatal period).

Allergic reactions: Extremely rarely - skin rashes, urticaria, itching, generalized exfoliative dermatitis, angioedema edema, anaphylactic reactions (including anaphylactic shock).

Others: Feeling heat, cold or numbness limbs, swelling, weakness, malignant hyperthermia.

Local reactions: The feeling of light burning disappearing with an increase in anesthetic effect (for 1 minute), hyperemia.

Overdose

It is possible to strengthen adverse reactions.

Symptoms: Psychomotor excitation, dizziness, general weakness, reduction of blood pressure, tremor, violation of vision, tonic-clonic convulsions, coma, collapse, AV blockade, asphyxia, apnea.

Treatment: Termination of the administration of the drug, oxygen therapy, anticonvulsants, vasoconstrictors (norepinephrine, mesonton), cholinolitics. The patient must be in a horizontal position; It is necessary to provide fresh air access, oxygen supply and / or carrying out artificial respiration. The symptoms from the CNS are adjusted by the use of benzodiazepines / barbiturates of short-term action. If an overdose arises in the anesthesia process, a short-range minelaxant should be applied. Atropine (0.5-1 mg intravenous) is used to correct bradycardia and conduction disorders, with arterial hypotension - sympathomimetics in combination with agonists of p-adrenoreceptors. When the heart is stopped, the immediate resuscitation activities are shown. Perhaps the intubation, artificial ventilation of the lungs. In the acute phase of overdose, dialysis is ineffective. No specific antidote.

Application in the periodbreastfeeding or breastfeeding

During pregnancy, the drug is contraindicated, as Lidocaine penetrates the placenta. In the body of the newborn, there are 40-55% of the concentration of the drug used by the Hife. In newborns, due to the low activity of hepatic enzymes, there is an increased risk of methemoglobinemia.

If necessary, applying the drug breastfeeding should be discontinued.

Children

The drug is prescribed during arrhythmias to children aged 12 years only in acute need with extreme caution.

Features of application

The introduction of lidocaine can only be carried out by medical workers. The solution of lidocaine 100 mg / ml is intended for intravenous infusion administration during the dilution by isotonic solution of sodium chloride.

When processing the injection site by disinfecting solutions containing heavy metals, the risk of developing a local reaction in the form of pain and edema increases.

During treatment, ECG monitoring is necessary. In sinus dysfunction, the elongation of the PQ interval, the expansion of QRS or the new arrhythmia should be reduced by the dose of the drug or discontinue treatment.

Before using lidocaine for heart disease (hypokalemia reduces the effectiveness of lidocaine) it is necessary to normalize the level of potassium in the blood.

With caution and in smaller doses are prescribed to patients with a warm deficiency of moderate degree, the arterial hypotension of moderate degree, incomplete AV blockade, disorders of intraventricular conductivity, disorders of the liver and kidney function of a moderate degree (creatinine clearance of at least 10 ml / min), impaired respiratory function, epilepsy, after operations on the heart, with genetic predisposition to malignant hyperthermia, weakened patients and older patients. The removal rate of lidocaine is reduced in patients with chronic heart failure and disorders of the liver function, which requires a decrease in two times the dose and the rate of administration of the drug.

In patients with hepatic insufficiency of methemoglobinemia Against the background of treatment with lidocaine, cyanosis is manifested, which requires the introduction of reducing substances (for example, methylene blue, etc.).

During the treatment period, Mao inhibitors should not use lidocaine parenterally.

It should be borne in mind that Lidocaine may cause a positive reaction when conducting control doping tests in athletes.

The ability to influence the reaction rate when managing motor vehicles andwhether to work with other mechanisms

Interaction with other drugsmi and other types of interactions

With the combined application of lidocaine with such drugs as chlorpromazine, ptyidine, bupivacaine, quinidine, dyspeyramide, amitriptyline, imipramine, northriptyline, The concentration of lidocaine in the blood plasma decreases.

Antiarrhythmic drugs (including amiodar, Verapamil, County, Dizeciramide,aimalin) - cardiodepressive action is enhanced (the Qt interval is lengthening and, in very rare cases, the development of AV blockade or ventricular fibrillation is possible). Amiodaron, while simultaneously appointed with lidocaine, reducing lidocaine metabolism, increases the risk of increasing its blood concentration with increasing side effects. If necessary, the simultaneous purpose of Lidocaine and Amiodaron is needed to observe the doctor, ecg- monitoring, if possible, monitoring the concentration of lidocaine in the blood, and the correction of the dose of lidocaine, including after the abolition of amiodarone.

Novocaine, Novocainamide, Prosanamide - It is possible to excite the CNS, nonsense, hallucinations. Strip-like drugs - Miorolaxation is enhanced (paralysis of respiratory muscles is possible). Ethanol. Enhances the depressing effect of lidocaine for breathing.

Cimetidine With a simultaneous purpose in a dose of more than 800 mg / day, reduces the liver clearance of lidocaine (due to the inhibiting microsomal oxidation in the liver), increases its concentration and risk of developing cardiological and neurological side effects. If you need to simultaneously assign the lidocaine and cimetidine, the doctor's observation is necessary, ECG monitoring, if possible, control the concentration of lidocaine in the blood, and correction of the dose of lidocaine, including after the cancellation of cimetidine.

β -Prenoblocators Slow down the metabolism of lidocaine in the liver, enhance the effects of lidocaine (including toxic) and increase the risk of bradycardia and arterial hypotension. With the simultaneous use of 0 adrenobloclain and lidocaine, it is necessary to reduce the dose of the latter.

Cardiac glycosides - The cardiotonic effect of heart glycosides is weakened.

Glycosides Natrestyanki - Against the background of intoxication, lidocaine can enhance the severity of AV blockade.

Sleeping or sedative drugs - It is possible to strengthen the depressing effect on the central and sedative CNS.

Narcotic analgesics (morphine et al.) - Increased analgesic effect of narcotic analgesics, inhibition of breathing.

Mao inhibitors (furazolidon, procarbazin, sELEGINE) - The risk of the development of arterial hypotension increases.

Anticoagulants (includingardeparin, dalteparin, danaparoid, Eanoxaparine, heparin, warfarin, etc.) Increase the risk of bleeding.

Means for anesthesia - Intensifying the oppressive effect on the respiratory center for anesthesia (hexobarbital, sodium thiopental intravenously).

Polymixin IN - need to control the respiratory function.

Rifampicin - It is possible to reduce the concentration of the latter in the blood.

Propapedon - It is possible to increase the duration and increase the severity of side effects from the CNS.

Predilamin - The risk of development of ventricular arrhythmia of the type "Pirouette" is increased.

Anticonvulsants, barbiturates (phenobarbital) - It is possible to accelerate the metabolism of lidocaine in the liver, reducing the concentration in the blood, strengthening the cardiodepressive effect.

Izadrin, glucagon - Lidocaine clearance increases.

Norepinephrin, mexylene - Lidocaine clearance decreases (toxicity increases); The hepatic blood flow decreases.

Acetazolamide, thiazide and loop diuretics Reduce the effect of lidocaine as a result of the creation of hypokalemia.

Midazolam - The concentration of lidocaine in the blood plasma increases.

Preparations that determine the blockade of neuromuscular transmission - The effect of these drugs is enhanced, since they reduce the conductivity of nerve impulses.

Pharmacological properties

Pharmacodynamics. The antiarrhythmic activity of the drug is due to the inhibition of phase 4 (diastolic depolarization) in Purkinier fibers, a decrease in automatism, the suppression of ectopic excitation foci. In this case, lidocaine suppresses the electrical activity of depolarized, arrhythmogenic sites, but minimally affects the electrical conductivity of normal tissues. The speed of fast depolarization (phase 0) does not affect or reduces slightly. Increases the permeability of membranes for potassium ions, accelerates the process of reolarization of cell membranes, shortens the duration of the potential of action and the effective refractory period. When applied in medium therapeutic doses, the myocardial cuts practically does not change, does not slow down AV conduction, does not reduce significantly blood pressure. When applied as an antiarrhythmic drug during intravenous administration, the action develops after 45-90 seconds, lasts 10-20 minutes; With intramuscular administration, the action develops after 5-15 minutes, lasts 60-90 minutes.

It has a topistanisy activity due to the stabilization of the neuronal membrane, a decrease in its permeability for sodium ions, which prevents the occurrence of the potential of action and carrying out impulses.

Pharmacokinetics. With intravenous administration, Cmax is achieved after 45-90 seconds, with intramuscular - after 5-15 minutes. Bonding with blood plasma proteins - 60-80% (depending on the dose). A stable concentration in the blood is set after 3-4 hours with continuous intravenous administration (in patients with acute myocardial infarction - after 8-10 hours). Easily passes through histohematic barriers, including the hematosphaliac. First enters the fabric with good blood supply (heart, lungs, brain, liver, spleen), then in fat and muscle tissue. Penetrates the placenta, in the body of the newborn, there are 40-55% of the concentration of the preparation used by the Hife. Therapeutic blood concentration on average - 0.0035 mg / ml.

Metabolized by 90% in the liver by oxidative N-dexychlorination with the formation of active metabolites: monoethylglycinxylindine and glycinxylinidine having T1 / 2 2 hours and 10 hours, respectively. It has the effect of "first passage".

T1 / 2 After intravenous bolus administration is 1.5-2 hours, with long intravenous infusions - up to 3 hours or more. If the T1 / 2 liver function is disrupted, it may increase more than 2 times. In unchanged form with urine, 5-20% is derived.

Openphysico-chemical properties

Transparent colorless or slightly painted solution.

Incompatibility

The drug should not be mixed with other drugs in one container, with the exception of solvents specified in the "Method of Application and Dose" section. Lidocaine falls into a precipitate when mixed with amphotericin, Methexithon or sulfadiazine. Depending on the pH of the lidocaine solution, may be incompatible with ampicillin.

On prescription.

Manufacturer

LLC "Pharmaceutical Company" Health ".

Location

Ukraine, 61013, Kharkov, ul. Shevchenko, 22.

Instructions for use:

Lidocaine is a means for local anesthesia.

pharmachologic effect

Lidocaine is used for conductor, infiltration, terminal anesthesia. The drug has a local and antiarrhythmic effect.

As anesthetic drug acts due to the oppression of nervous conductivity due to the blockade of sodium channels in nerve fibers and endings. Lidocaine significantly exceeds the plot, its action is faster and it is longer - up to 75 minutes (in combination with epinephrine - more than two hours). Lidocaine under local application expands the vessels, the ceiling action does not exert.

The antiarrhythmic effect of the drug is due to the ability to increase the permeability of potassium membranes, block soda channels, stabilize cell membranes.

Lidocaine does not have a significant effect on the reduction, the conductivity of the myocardium (acts only in large doses).

The level of lidocaine absorption during local application depends on the dosage of the means and placement location (for example, lidocaine on the mucous membranes is absorbed better than on the skin).

After intramuscular injections, lidocaine maximum concentration reaches 5-15 minutes after administration.

Form release

Lidocaine spray, lidocaine in ampoules (with enclosure solution).

Indications for the use of lidocaine

Prix \u200b\u200bLidocaine 2% is used for local anesthesia in dentistry, surgery, ophthalmology, otolaryngology, for blockade of nervous plexuses, peripheral nerves in patients with pain.

Lidocaine in ampoules is 10% used for anesthesia in the form of appliques of mucous membranes in LOR-Practices, gynecology, pulmonology, gastroenterology, dentistry during operations, diagnostic manipulations. 10% solution and as an antiarrhythmic agent are used.

Lidocaine spray is used in dentistry to remove dairy teeth, tartar, fixation of dental crowns, conducting other manipulations requiring short anesthesia; In otolaryngology - for tonsilectomy, truncation of nasal polyps, partitions, painting of the process of piercing and washing the gaimore sinus.

Spray Lidocaine is effective when conducting diagnostic manipulations (introduction of a gastroduodenal probe, replacing the tracheotomic tube) for anesthesia of the pharynx.

In gynecology, spray is used when removing seams, dissection of a female perineum during childbirth, conducting operations on the cervix.

In dermatology, spray is used to pain relieve mucous, skin when carrying out minor surgical procedures.

Contraindications

Lidocaine according to the instructions are contraindicated in the blockade of atrioventricular 2,3rd degree, the insufficiency of the cardiac 2,3rd degree, pronounced bradycardia, hypotension of arterial, shock cardiogenic, full transverse cardiac blockade, porphyria, myasthenia, pronounced renal, liver pathologies, hypovolemia, glaucoma (for eye injections ), hypersensitivity, lactation, pregnancy.

Spray Lidocaine with caution is prescribed to weakened, elderly patients, children, patients with epilepsy, in shock states, in bradycardia, pathology of liver function, conductivity disorders, pregnancy. During the lactation, the spray can be used only in recommended dosages.

Instructions for the use of lidocaine

Before applying Lidocaine, according to the instructions, an allergic should be carried out to identify possible sensitivity to the drug. If there is edema or redness, it is impossible to apply lidocaine for anesthesia.

A solution of 2% lidocaine (in ampoules) is designed for subcutaneous, intramuscular administration, conductor anesthesia, instillation in a conjunctival bag, processing mucous membranes.

The dosage of the drug is individual, but in the Lidocaine instructions such mean dosages are indicated: 100-200 mg of the means (no more than 200mg) are used for conducting anesthesia, for the anesthesia of the nose, ears, fingers - 40-60 mg of the drug.

When appointing lidocaine injections, an epinephrine is additionally prescribed to achieve the maximum therapeutic effect (if there are no contraindications).

In ophthalmology, drip up to six drops of solution, driving two drops every 30-60 seconds. Usually 4-6 cap. One eye is enough for anesthesia before carrying out operations, diagnostic manipulations.

For terminal anesthesia, the maximum allowable dose of lidocaine according to the instructions is 20 ml. Duration of processing - 15-30 minutes.

When conducting anesthesia to children, the total dosage should not exceed 3 mg per kg of child weight.

The solution of 10% of lidocaine (in ampoules) is injected intramuscularly and used as applications. The permissible volume of lidocaine for applications is 2 ml.

To stop the arrhythmic attack make the intramuscular injection of lidocaine - 200-400 mg. Ate the attack is not stopped, after three hours they make re-injection.

When arrhythmias can be administered 1, 2% solution intravenously inkjet - 50-100 mg, after that the Lidocaine instructions are injected intramuscularly.

Using lidocaine in ampoules 2 and 10% should be monitored by the ECG, refrain from disinfection of the area of \u200b\u200binjections with heavy metals in composition.

When appropriate means in high doses, barbiturates are taken before the dam.

Spray Lidocaine apply only locally. Spray the drug from a short distance directly to the place that requires anesthesia, avoiding his eyes, respiratory tract.

When irrigating the oral cavity due to a reduction in sensitivity, caution should be taken, so as not to damage the tongue to the teeth.

In dentistry, dermatology is used for 1-3 doses of 10% lidocaine; in otolaryngology, cranial-facial surgery - 1-4 doses of 10% lidocaine; for endoscopic examination - 2-3 doses of 10% RR; In gynecology - 4-5 doses (while in obstetric practice it is allowed to use up to 20 doses of 10% solution).

When processing extensive areas, you can use a tampon, irrigated by lidocaine from the balllong.

Side effects

After the drug, weakness may occur, headache, nystagm, fatigue, euphoria, light-friendly, hearing impairment, numbness of the language, lips, drowsiness, nightmares, diplopia (shots in the eyes), violation of the rhythm and conductivity of the heart, transverse heart block, lower pressure, Pain in chest, paresthesia, air palsy muscles, sensitivity violation, cramps, tremor.

Lidocaine in large doses can lead to a heart blockade, collapse, heart stop.

Also, the drug may cause shortness of breath, apnea, allergic rhinitis, conjunctivitis, dermatitis, dysnae, urticule, shock anaphylactic, nausea, vomiting, decrease in body temperature, feeling of heat, chills, numbness of limbs, soreness in the place where Lidocaine injections were injected.

Spray Lidocaine can provoke: a feeling of burning, allergic manifestations, pressure drop, heart attack, depression, drowsiness, anxiety, loss of consciousness, spasms, airway paralysis, irritability

Formula: C14H22N2O, chemical name: (2-diethylamino) -N- (2,6-dimethylphenyl) acetamide (and in the form of hydrochloride).
Pharmacological group: Organotropic agents / Cardiovascular agents / Antiarrhythmic agents of class 1b;
Neurotropic agents / Local anesthetics / acetanide derivative.
Pharmachologic effect: Antiarrhythmic, topless.

Pharmacological properties

The antiarrhythmic properties of lidocaine are due to the inhibition of diastolic depolarization in Purkinier fibers, the suppression of ectopic excitation foci, reduced automatism. On the speed of rapid depolarization, Lidocaine does not affect or slightly lowers it. Lidocaine increases the permeability of the cell shell for potassium ions, makes the rapid process of repolarization and shorter the potential of action. Lidocaine The excitability of the sinus-atrial node does not change, slightly affects the reduction and conductivity of myocardium. When administered intravenously, it acts briefly and quickly (10-20 minutes). The mechanism of the local peculiar properties of Lidocaine is to stabilize membranes of neurons, reduce their permeability for sodium ions, this does not allow the capacities of action and conducting pulses. In the weakly alkaline medium of tissues, Lidocaine is quickly hydrolyzed and after a short latent period has an action for 1 - 1.5 hours. With inflammation, the anesthetic activity of lidocaine is reduced due to an acid medium at the place of inflammation.
With all types of local anesthesia, lidocaine is effective. Lidocaine irritating on fabric does not have, expands vessels; An antagonism is possible with calcium ions. When administered intravenously, the maximum concentration is created after 45 - 90 seconds, when administered intramuscularly - after 5 - 15 minutes. Quite quickly, lidocaine is absorbed from the mucous membrane of the oral cavity or upper respiratory tract (the maximum concentration is achieved after 10-20 minutes). When taking lidocaine inside, bioavailability is only 15-35% (due to the effects of the "first passage" through the liver). Plasma proteins are associated with 50-80%. In the blood, a stable concentration is achieved after 3-4 hours with continuous administration of intravenously (in patients with acute myocardial infarction - after 8-10 hours). The therapeutic effect develops at a concentration of 1.5-5 μg / ml. Lidocaine easily penetrates through various barriers, including the hematorecephalic, placental barriers, enters breast milk. At first, Lidocaine enters well blood supplying fabrics (lungs, heart, brain, spleen, liver), then in muscle and fatty tissue.
The half-life when intravenous bolus administration is 1.5-2 hours (3 hours in newborns), with long intravenous infusions - up to 3 hours and even more. If the liver is violated, the timeline half-life can increase more than 2 times. Almost completely and quickly, lidocaine is metabolized in the liver (with urine unchanged less than 10% is removed in the process of oxidative N deelling, the active metabolites (glycinxylideine and monoethylglycinxylideine) are formed in this process, which have half-life, respectively, 10 hours and 2 hours. In patients with chronic renal failure, accumulation in the organism of lidocaine metabolites is possible. The duration of the action of lidocaine during intravenous administration is 10-20 minutes with intramuscular administration and 60-90 minutes. When used locally in the form of plates on intact skin, the therapeutic effect, sufficient to relieve pain, occurs, and the system effects do not develop.

Indications

Ventricular fibrillation; ventricular tachyarhythmias and extrasystoles, including in the postoperative period, and in acute myocardial infarction; All kinds of local anesthesia, including surface, infiltration, conductive, epidural, spinal, intraligative during painful manipulations, operational interventions, instrumental and endoscopic studies; In the form of plates - myositis, painful syndrome with spine lesions, postherpetic neuralgia.

The method of applying lidocaine and dose

Dosing mode is established individually, depending on the clinical situation, indications and the dosage form used. When arrhythmia: intravenously (for 3-4 minutes), 50-100 mg stroke at a rate of 25-50 mg / min, then at a rate of 1-4 mg / min drip; intramuscularly 4.3 mg / kg body weight, it may be reused after 1 - 1.5 hours; For intravenous and intramuscular administration, the maximum dose for adults is equal to 300-400 mg for 1 hour; The maximum daily dose is 2000 mg. Children with a speed of 25-50 mg / min are introduced insertion 1 mg / kg, after 5 minutes it is possible to repeat the introduction (the total dose should not be more than 3 mg / kg), then administered at a rate of 30 μg / kg / min; The maximum daily dose is 4 mg / kg. Surface anesthesia - 2-10% solution (no more than 200 mg - 2 ml). Infiltration Anesthesia Adults Use 0.5% solution, conductive - 1-2% solution. The maximum total dose is 300-400 mg. In ophthalmology, 1-2 drops are introduced 2-3 times with an interval of 30-60 seconds. Locally (aerosol, gel, spray, plates). Children under 2 years old for surface anesthesia are prescribed, pre-applying on cotton swab, 1-2 aerosol doses (4.8-9.6 mg). Plates are glued to the skin, covering a painful surface. After applying the plate you need to wash your hands right away. For 12 hours, the plate may be on the skin. Next, it is removed and take a break at 12 o'clock. At the same time, you can use no more than 3 plates.
To prolong the action of lidocaine, add to 5-10 ml of lidocaine 1 drop of 0.1% of the adrenaline solution. Care must be taken when taking lidocaine patients with diseases of the kidneys, liver, severe heart failure with a reduction impairment, hypovolemia, genetic predisposition to malignant hypertermia. Children, weakened patients, the elderly patients are needed in accordance with the physical status and age correction of the dose. When the lidocaine is introduced into vascularized tissues, an aspiration sample must be carried out. Use Lidocaine locally in the field of infection or injury must be carefully. If redness of the skin occurred during the use of the plate, then the plate must be removed and not to use redness or burning. Immediately after using the plate, it is necessary to destroy that children or pets cannot reach them.

Contraindications for use

Hypersensitivity, Heart Blockers (intraventricular, AV, sine-atrial), weakness of a sinus node, cardiogenic shock, WPW syndrome, Miasthenia, severe liver diseases, a history of epileptiform seizures when using lidocaine.

Restrictions on application

Breastfeeding, pregnancy, age more than 65 years, progression of cardiovascular failure, weakened patients, conditions that are accompanied by a decrease in liver blood flow; Skin integrity disorders (at the place of use of plates).

Application in pregnancy and breastfeeding

You can use lidocaine during breastfeeding and during pregnancy, if the expected effects of therapy for the mother are above the possible risk for a child or fetus.

Side effects of Lidocaine

Nervous system and sense organs: Excitation or inhibition of the central nervous system, nervousness, flickering "flies" before your eyes, euphoria, photophobia, headache, drowsiness, dizziness, diplopia, noise in ears, violation of consciousness, stop or inhibition of breathing, tremor, disoritation, muscle twitching, cramps ( The possibility of their development increases with hypercaps and acidosis);
circulation system: Heart conductivity violation, sinus bradycardia, transverse blockade of the heart, increase or decrease in blood pressure, collapse;
digestive system: nausea, vomiting;
allergic reactions: anaphylactic shock, generalized exfoliative dermatitis, contact dermatitis (skin rash, hyperemia at the place of application, itching, urticaria), angioedema, shortness of the aerosol, or in the place of the plates application;
others: Feeling cold, heat or numbness of limbs, depression of the immune system, malignant hyperthermia.

The interaction of lidocaine with other substances

Beta-adrenoblastors increase the possibility of hypotension and bradycardia when used with lidocaine. Beta-adrenoblays and norepinephrine, due to reduction of hepatic blood flow, reduce lidocaine clearance (lidocaine toxicity increases), glucagon, isoprenaline - increase lidocaine clearance. Cimetidine increases the content of lidocaine in plasma. Barbiturates, due to the induction of microsomal enzymes, activate the degradation of lidocaine and, thus, reduce its activity. Anticonvulsant preparations (derivatives of hydantoin) accelerate the biotransformation of lidocaine in the liver. Antiarrhythmics (verapamil, aimaline, amiodarone, quinidine) potentiate cardiodepression when sharing with lidocaine. Sharing lidocaine and novocainamide can cause hallucinations and excitation of the central nervous system. Lidocaine enhances the inhibitory effect of sleeping pills and anesthesive drugs to the respiratory center, deepens the muscle relaxation, which is caused by rapid drugs, weakens the cardiotonic effects of digitoxine. Inhibitors of Mao will prolong local Lidocaine anesthesia.

Overdose

With the overdose of the lidocaine, psychomotor excitation occurs, the total weakness, dizziness, hypotension, tremor, coma, tonic-clonic convulsions, collapse, the oppression of the central nervous system, the AV blockade, the respiratory stop. It is necessary: \u200b\u200bstopping the reception of lidocaine, oxygen therapy, pulmonary ventilation, intake of anticonvulsant drugs, vasoconstrictors (Meston, Noradrenalin), in the development of bradycardia - cholinolities (atropine); If necessary, conducting resuscitation activities, lung intubation, IVL. Dialysis is ineffective.

Trade names of drugs with the active substance Lidocaine

Versatius
Gelicain
Dinekman
Xylocaine

Lidocaine
Lidocaine buffus
Lidokain-Vial
Lidocaine hydrochloride

Lidocaine hydrochloride 1% Brown
Lidocaine hydrochloride 2% Brown
Lidocaine hydrochloride solution for injection
Luran