Lidocaine

Lidocaine Brand Names

7T Lido | Akten | ANASTIA | AneCream | Anestacon | Aspercreme with Lidocaine | Astero | BenGay | Blue Tube | Blue-Emu | CidalEaze | Ela-Max | EnovaRX | GEN7T | Glydo | LidaMantle | Lidocare | Lidoderm | LidoDose | LIDO-K | Lidomar | LidoRx | Lidosense 4 | Lidosense 5 | LIDO-SORB | Lidotral | LIDOZION | LMX 4 | LMX 4 with Tegaderm | LMX 5 | LTA | Numbonex | RectaSmoothe | RectiCare | Salonpas Lidocaine | Senatec | Solarcaine | Tranzarel | Xylocaine | Xylocaine MPF | Xylocaine Viscous | Zilactin-L | Zingo | Zionodi | ZTlido

What is Lidocaine

Lidocaine is a widely used antiarrhythmic and amide-type local anesthetic. As an anesthetic agent, it is available as an ointment, jelly, patch, or aerosol for topical use, as an oral solution, and as an injection.

Lidocaine is classified as a class Ib antiarrhythmic. It may be considered for ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) that is unresponsive to cardiopulmonary resuscitation (CPR), defibrillation, and vasopressor therapy.

Evidence is inadequate regarding the routine use of lidocaine after cardiac arrest or early (within the first hour) after return of spontaneous circulation (ROSC). However, prophylactic use of lidocaine may be considered in certain circumstances (e.g., during emergency medical services transport) when treatment of recurrent VF/pVT may be challenging.

Due to the potential for serious adverse reactions, including cardiovascular depression, continuous electrocardiogram monitoring is recommended during intravenous lidocaine treatment.

There is limited evidence suggesting that nebulized lidocaine exhibits steroid-sparing effects when used in corticosteroid-dependent asthmatics.

However, extreme caution is recommended until long-term safety and efficacy can be established.

Indications

  1. asthma
  2. cardiopulmonary resuscitation
  3. caudal anesthesia
  4. dental anesthesia
  5. dental pain
  6. diabetic neuropathy
  7. epidural anesthesia
  8. headache
  9. increased intracranial pressure
  10. infiltration anesthesia
  11. local anesthesia
  12. mandibular nerve block
  13. migraine
  14. neuropathic pain
  15. obstetric anesthesia
  16. ophthalmic anesthesia
  17. paracervical block
  18. peripheral nerve block
  19. postherpetic neuralgia
  20. rapid-sequence intubation
  21. regional anesthesia
  22. short-lasting unilateral neuralgiform headache with conjunctival injection and tearing
  23. singultus (hiccups)
  24. spinal anesthesia
  25. status epilepticus
  26. stellate ganglion block
  27. stomatitis
  28. sympathetic nerve block
  29. topical anesthesia
  30. ventricular fibrillation
  31. ventricular tachycardia

Side Effects

  1. agitation
  2. anaphylactic shock
  3. anaphylactoid reactions
  4. angioedema
  5. anxiety
  6. arachnoiditis
  7. arrhythmia exacerbation
  8. asthenia
  9. back pain
  10. blurred vision
  11. bradycardia
  12. bronchospasm
  13. cardiac arrest
  14. chondrolysis
  15. confusion
  16. conjunctival hyperemia
  17. corneal opacification
  18. cranial nerve palsies
  19. decreased uterine contractility
  20. dizziness
  21. drowsiness
  22. dysarthria
  23. dysesthesia
  24. dysgeusia
  25. dyspnea
  26. ecchymosis
  27. edema
  28. erythema
  29. euphoria
  30. fecal incontinence
  31. fetal acidosis
  32. fetal bradycardia
  33. flushing
  34. headache
  35. hot flashes
  36. hyperesthesia
  37. hypoesthesia
  38. hypotension
  39. injection site reaction
  40. laryngospasm
  41. malignant hyperthermia
  42. meningitis
  43. metallic taste
  44. methemoglobinemia
  45. nausea
  46. neonatal depression
  47. neuropathic pain
  48. ocular irritation
  49. paresthesias
  50. petechiae
  51. pruritus
  52. respiratory arrest
  53. respiratory depression
  54. restlessness
  55. seizures
  56. shivering
  57. skin discoloration
  58. skin erosion
  59. skin irritation
  60. tinnitus
  61. tremor
  62. urinary incontinence
  63. urinary retention
  64. urticaria
  65. visual impairment
  66. vomiting
  67. weakness

Monitoring Parameters

  • ECG
  • serum lidocaine concentrations

Contraindications

  • accidental exposure
  • Adams-Stokes syndrome
  • amide local anesthetic hypersensitivity
  • anticoagulant therapy
  • atrial fibrillation
  • atrial flutter
  • AV block
  • bleeding
  • bradycardia
  • breast-feeding
  • burns
  • cardiac disease
  • cardiogenic shock
  • cataracts
  • children
  • coagulopathy
  • collagen-vascular disease
  • continuous intraarticular infusion administration
  • eczema
  • epidural anesthesia
  • fetal distress
  • fetal prematurity
  • G6PD deficiency
  • geriatric
  • head and neck anesthesia
  • heart failure
  • heating pad
  • hemorrhagic shock
  • hepatic disease
  • hypotension
  • hypovolemia
  • infants
  • infection
  • intraarterial administration
  • intrathecal administration
  • intravenous administration
  • labor
  • malignant hyperthermia
  • methemoglobinemia
  • neonates
  • neurological disease
  • obstetric delivery
  • occlusive dressing
  • ocular exposure
  • ocular surgery
  • ocular trauma
  • paracervical nerve block
  • pregnancy
  • pudendal nerve block
  • pulmonary disease
  • renal disease
  • renal failure
  • renal impairment
  • requires a specialized care setting
  • requires an experienced clinician
  • sepsis
  • shock
  • skin abrasion
  • spinal anesthesia
  • teething pain
  • thrombocytopenia
  • Wolff-Parkinson-White syndrome

Interactions

  • Acebutolol
  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
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