lidocaine where to inject?
LIDOCAINE (LYE doe kane) is an anesthetic. It causes loss of feeling in the skin or other tissues. It is used to prevent and to treat pain from some procedures.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
COMMON BRAND NAME(S): Lidomark, ReadySharp Lidocaine, Xylocaine, Xylocaine MPF
They need to know if you have any of these conditions:
•an unusual or allergic reaction to lidocaine, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
This medicine is for injection into the affected area. It is given by a health care professional in a hospital or clinic setting.
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
This does not apply.
Do not take this medicine with any of the following medications:
•MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
This medicine may also interact with the following medications:
•medicines for blood pressure, heart disease, or irregular heart beat
•medicines for depression, anxiety, or psychotic disturbances
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
Your condition will be monitored carefully while you are receiving this medicine.
Be careful to avoid injury while the area is numb and you are not aware of pain.
Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•changes in vision
•feeling faint or lightheaded, falls
•slow, irregular heartbeat
•trembling or shaking
•unusually weak or tired
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•anxiety or nervousness
•feelings of cold, heat, or numb
•irritation at site where injected
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
The usual adult IV bolus dose is 50-100 mg administered at a rate of approximately 25-50 mg per minute. If the desired response is not achieved, a second dose may be administered 5 minutes after completion of the first injection. Not more than 200-300 mg should be administered during a one hour period. Elderly patients and those with congestive heart failure or cardiogenic shock may require smaller bolus doses.
Maintenance infusion of a 0.2 or 0.4% solution in 5% glucose.
Adults: 20-50 micrograms/kg/minute (1-4 mg/minute in an average 70 kg adult).
Slower infusion rates should be used in patients with congestive heart failure or liver disease; no dosing modification appears necessary in patients with renal failure. When arrhythmias reappear during a constant infusion of Lidocaine, a small bolus may be given to rapidly increase plasma concentration of the drug; the infusion rate is increased simultaneously. The infusion should be terminated as soon as the patient's basic cardiac rhythm appears to be stable or at the earliest sign of toxicity.
Infants and children may be given an initial IV bolus of 0.5-1 mg/kg. This dose may be repeated according to the response of the patient, but the total dose should not exceed 3-5 mg/kg. A maintenance IV infusion of 10-50 micrograms/kg per minute may be given via an infusion pump.
For advanced cardiac life support in children, the recommended dosage is an initial IV bolus of 1 mg/kg. If ventricular tachycardia or ventricular fibrillation is not corrected following defibrillation and an initial bolus, an IV infusion should be started at a rate of 20-50 mcg/kg per minute.
Constant ECG monitoring is recommended during therapy with Lidocaine Hydrochloride, however if this equipment is not available and a ventricular arrhythmia is suspected, a single IM dose may be administered if bradycardia is not present. The deltoid muscle is the preferred site for IM injection.
Usual doses should generally be reduced in children and in elderly or debilitated patients. To minimise the possibility of toxic reactions, children should be given Lidocaine Hydrochloride solutions in concentrations of 0.5% or 1%.
Single doses of Lidocaine (for anaesthesia other than spinal) should not exceed 4.5 mg/kg (or 200 mg) in adults or children 12 – 18 years of age. Lidocaine by local infiltration for children under the age of 12 years should not exceed 3mg/kg, repeated not more often than every 4 hours.
For spinal anaesthesia, up to 100 mg of the drug may be given. For continuous epidural or caudal anaesthesia, the maximum dose should not be repeated at intervals of less than 1.5 hours. For paracervical block for obstetric analgesia (including abortion) the maximum recommended dosage (200 mg) should not be repeated at intervals of less than 1.5 hours. For IV regional anaesthesia in adults using a 0.5% solution, the dose administered should not exceed 4 mg/kg.
Solutions of 1% Lidocaine Hydrochloride (without preservative) are used for epidural or caudal anaesthesia. To prevent intravascular or subarachnoid injection of a large epidural dose of Lidocaine, a test dose of 2-5 mls should be injected at least 5 minutes prior to administering the total dose.
In epidural anaesthesia 2-3 mls of 1% solution is usually required for each dermatome to be anaesthetised.
In caudal block for production of obstetric analgesia or in epidural thoracic block, 20-30 mls of a 1% solution (200-300 mg) of the drug may be used. For epidural lumbar anaesthesia, the dose is 25-30 mls (250-300 mg) of a 1% solution.
For intercostal nerve block: 3 mls of a 1% solution (30 mg).
For paravertebral nerve block: 3-5 mls of a 1% solution (30-50 mg).
For pudendal nerve block (each side): 10 mls of a 1% solution (100 mg).
For paracervical nerve block (each side) for obstetric analgesia: 10 mls of a 1% solution (100 mg).
For sympathetic nerve blocks: Cervical (stellate ganglion) nerve block: 5 mls of a 1% solution (50 mg).
Lumbar nerve block: 5-10 mls of a 1% solution (50-100mg).
For percutaneous infiltration anaesthesia: 1-60 mls of a 0.5% solution or 0.5 to 30ml of a 1% solution (5-300mg).
Lidocaine should be used with caution in patients receiving other local anaesthetics or agents structurally related to amide-type local anaesthetics (e.g. anti-arrhythmics, such as mexiletine), since the systemic toxic effects are additive. Specific interaction studies with lidocaine and class III anti-arrhythmic drugs (e.g. amiodarone) have not been performed, but caution is advised.
There may be an increased risk of enhanced and prolonged neuromuscular blockade in patients treated concurrently with muscle relaxants (e.g. suxamethonium).
Effects of other medicinal products on Lidocaine
There may be an increased risk of ventricular arrhythmia in patients treated concurrently with antipsychotics which prolong or may prolong the QT interval (e.g. pimozide, sertindole, olanzapine, quetiapine, zotepine), or 5HT3 antagonists (e.g. tropisetron, dolasetron).
Concomitant use of quinupristin/dalfopristin should be avoided.
Hypokalaemia produced by acetazolamide, loop diuretics and thiazides antagonises the effect of lidocaine.
It is given through a needle placed into one of your veins, into your upper arm, into the head and neck area, or into the space around the spinal nerves in your lower back.
Generic name: lidocaine injection Brand names: Xylocaine HCl, Xylocaine-MPF, Lidoject 1, Xylocaine Dental Cartridges, Lidoject 2, ... show all 13 brands Xylocaine Duo-Trach Kit, Xylocaine HCl For Spinal, L-Caine, Dilocaine, Nervocaine, Truxacaine, UAD Caine, Anestacaine Dosage forms: injectable solution (0.5%; 0.5% preservative-free; 1.5% preservative-free; 1%; 1% preservative-free; 1%-NaCl 0.9%; 2%; 2% preservative-free; 4% preservative-free; 5%-0.4%; 5%-0.8%; 7.5%-5%), intravenous solution (1% preservative-free; 2% preservative-free) Drug classes: Group I antiarrhythmics, Local injectable anesthetics
Medically reviewed by Drugs.com on Sep 13, 2022. Written by Cerner Multum.
Lidocaine is a local anesthetic (numbing medication) that is used to numb an area of your body to help reduce pain or discomfort caused by invasive medical procedures such as surgery, needle punctures, or insertion of a catheter or breathing tube.
Lidocaine injection is sometimes used to treat irregular heart rhythms that may signal a possible heart attack.
Lidocaine injection is also given in an epidural (spinal block) to reduce the discomfort of contractions during labor.
Lidocaine injection may also be used for purposes not listed in this medication guide.
You should not receive lidocaine injection if you have severe heart block, or a heart rhythm disorder called Stokes-Adams syndrome or Wolff-Parkinson-White Syndrome.
You should not receive this medicine if you are allergic to lidocaine injection or any other type of numbing medicine, or if you have:
Tell your doctor if you have ever had:
Tell your doctor if you are pregnant or breastfeeding.
A healthcare provider will give you this injection.
When used to treat heart rhythm problems, lidocaine is given as an infusion into a vein.
When used as a local anesthetic, lidocaine is injected through the skin directly into the body area to be numbed.
Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are receiving lidocaine injection in a hospital setting.
If you are being treated for irregular heart rhythm, your heart rate will be constantly monitored using an electrocardiograph or ECG (sometimes called an EKG). This will help your doctor determine how long to treat you with lidocaine injection.
Since lidocaine injection is used only when needed in a clinical setting, you are not likely to miss a dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Lidocaine injection can cause side effects that may impair your thinking or reactions. Unless absolutely necessary, do not drive after receiving lidocaine injection.
Avoid eating or chewing within 1 hour after lidocaine injection is used to numb your mouth or throat. You may have trouble swallowing which could lead to choking. You may also accidentally bite the inside of your mouth if you are still numb an hour after treatment with lidocaine injection.
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Tell your caregiver right away if you have:
Common side effects of lidocaine injection may include:
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Tell your doctor about all your other medicines, especially:
This list is not complete. Other drugs may affect lidocaine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.