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
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• Acetaminophen; Caffeine; Dihydrocodeine
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• 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
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