Index of drugs

Regional anesthesia - ascites, nerve blockages, nerve trunks and nerve plexuses - in general surgery, urology, orthopedics, gynecology, obstetrics, dentistry, also in various diagnostic and therapeutic procedures.

1 ampoule of 2 ml contains 40 mg of Lidocaine and 0.05 mg of L-noradrenaline.

Lidocaine is a local anesthetic and antiarrhythmic drug with amide structure. It inhibits the formation and conduction of stimuli in the nerve fibers and the heart-conduction system of the heart. Lidocaine blocks the sodium channels of nerve cell membranes. Inhibition of ion inflow Na⁺ prevents generation and conduction of impulses appearing in response to depolarization. The threshold of excitability of nerve fibers increases until complete conduction is blocked. The concentration of lidocaine blocking the conductivity is inversely proportional to the diameter of the fiber. In the first place, thin fibers are blocked. pain, then thicker - sensory. In order to block the motor fibers (the thickest ones), the highest concentrations of lidocaine are necessary. Noradrenaline shrinks the blood vessels. The addition of a sympathomimetic drug aims to reduce the absorption of lidocaine from the site of administration. At higher doses systemic effects of noradrenaline may occur. Lidocaine is completely absorbed from the place of depositing in the tissues. The speed of its concentration in the blood depends on many factors, of which the place of administration is important. The highest concentration of lidocaine in the plasma is found during intercostal nerve blockage, slightly lower in epidural patients, while the lowest concentration is observed during the anesthesia. The degree of binding of lidocaine to proteins depends on its plasma concentration. At concentrations of 1 μg / ml to 4 μg / ml, 40% to 80% of the drug is associated with proteins. Lidocaine crosses the blood-brain barrier and through the placenta, reaching the fetal circulation. It is rapidly metabolized in the liver to several metabolites - N-dealkylated derivatives. The drug is excreted via the kidneys primarily in the form of metabolites, and only 10% in unchanged form. After intravenous injection of T_0,5 is 1.6 h. Lymphocyte kinetics vary in people with impaired hepatic function and in these cases elevated blood metabolites are found. The addition of norepinephrine limits the rate of absorption of lidocaine from the tissues into the bloodstream, thus prolonging the duration of action and reducing its concentration in the serum, which allows the use of a higher dose.

Hypersensitivity to lidocaine or other local anesthetics with amide structure, or any of the ingredients.

Due to the addition of noradrenaline, caution should be exercised in patients with cardiovascular diseases (hypertension, coronary heart disease, mitral stenosis), diabetes mellitus, adrenal pheochromocytoma, hyperthyroidism, and narrow-angle glaucoma.
Warning. Do not use local anesthesia with the addition of vasoconstrictor drugs in regions where vasoplasty may cause necrosis or adverse ischemia (so-called anatomically or functionally vascular): in the fingers (practically - peripherally from the wrist or ankle), nose, ears, penis.

Due to the lack of controlled examinations in pregnant women, the preparation can be used only in extreme necessity. Lidocaine is excreted in human milk in small amounts, therefore its use during breastfeeding requires caution.

Undesirable effects of lidocaine are usually the result of excessive increase in its concentration in body fluids as a result of too high a dose, disturbances in kinetics or inadequate injection technique.Symptoms of lidocaine poisoning: from the side of the CNS: metallic taste in the mouth, feeling of bewilderment, agitation, anxiety, euphoria, muscle tremors, disturbed consciousness, headache and dizziness, nausea, tinnitus, blurred vision, vomiting, feeling hot, cold or numbness, loss of consciousness, convulsions, CNS depression; on the part of the circulatory system: drop in blood pressure, bradycardia, and in extremely severe cases, cardiac arrest. Allergic reactions after using lidocaine are extremely rare and usually have the character of skin lesions, urticaria, edema, anaphylactoid symptoms.

As a local analgesic: used in solutions: anesthesia: 0.5-2.0%; anesthesia of nerves and nerve plexuses: 0.5-2%. The volumes of the given solutions depend on the indications, the technique of anesthesia (for details see professional literature) and the the patient. Do not exceed the dose of lidocaine 7 mg / kg. (if using a vasodilator).