What Is a Lidocaine Injection?

Lidocaine hydrochloride injection, a local anesthetic and an antiarrhythmic drug. It is mainly used for infiltration anesthesia, epidural anesthesia, surface anesthesia (including mucosal anesthesia during thoracoscopy or abdominal surgery) and nerve conduction block. This product can be used for premature ventricular contractions and ventricular tachycardia after acute myocardial infarction. It can also be used for digitalis poisoning, cardiac surgery and ventricular arrhythmias caused by cardiac catheters. This product is usually ineffective for supraventricular arrhythmias.

Drug Name: Lidocaine Hydrochloride Injection

Drug type: Work Injury Medical Insurance Class A Double Span
Use classification: Antitachycardia

Lidocaine Hydrochloride Injection Composition

Main ingredients of this product: Lidocaine hydrochloride Chemical name: N- (Dichloroxylyl) -2- (diethylamino) acetamide hydrochloride Monohydrate Chemical structural formula:

Molecular formula: C ₁₄ H ₂₂ N ₂ O · HCI · H ₂ 0
Molecular weight: 288.82

Properties of Lidocaine Hydrochloride Injection

This product is a clear, colorless liquid.

Indications of lidocaine hydrochloride injection

This product is a local anesthetic and an antiarrhythmic drug. It is mainly used for infiltration anesthesia, epidural anesthesia, surface anesthesia (including mucosal anesthesia during thoracoscopy or abdominal surgery) and nerve conduction block. This product can be used for premature ventricular contractions and ventricular tachycardia after acute myocardial infarction. It can also be used for digitalis poisoning, cardiac surgery and ventricular arrhythmias caused by cardiac catheters. This product is usually ineffective for supraventricular arrhythmias.

Lidocaine Hydrochloride Injection Specifications

(1) 5ml: 0.1g; (2) 10ml: 0.2g

Lidocaine Hydrochloride Injection Dosage

1. For anesthesia (1) Usual amount for adults:
Surface anesthesia: 2% ~ 4% solution should not exceed 100mg at a time. For injection, do not exceed 4.5 mg / kg once (no epinephrine) or every 7 mg / kg (epinephrine with a concentration of 1: 200000).
sacral block used for labor analgesia: use 1.0% solution, limited to 200mg.
epidural block: 1.5% ~ 2.0% solution for thoracolumbar, 250 ~ 300mg.
Block infiltration anesthesia or intravenous injection: use 0.25% ~ 0.5% solution, 50 ~ 300mg.
Peripheral nerve block: Brachial plexus (unilateral) with 1.5% solution, 250 ~ 300mg; dental 2% solution, 20 ~ 100mg; intercostal nerve (each) with 1% solution, 30mg, 300mg as limit; cervical Use 0.5% ~ 1.0% solution for lateral infiltration, 100mg on left and right sides; 1.0% solution for paravertebral spinal nerve block (per branch), 30 ~ 50mg, 300mg as limit; 0.5% ~ 1.0% solution for pudendal nerve, left and right sides 100mg.
Sympathetic ganglion block: 1.0% solution for cervical stellate nerve, 50mg; 1.0% solution for spinal anesthesia, 50 ~ 100mg.
One time limit, 200mg (4mg / kg) without epinephrine, 300 ~ 350mg (6mg / kg) with epinephrine; block of intravenous injection, maximum 4mg / kg; intravenous injection for treatment, first time The amount is 1 ~ 2mg / kg, the extreme amount is 4mg / kg, the adult intravenous drip is limited to 1mg per minute; repeated administration, the interval should not be shorter than 45 ~ 60 minutes.
(2) The amount commonly used in children varies from individual to individual. The total amount for one administration should not exceed 4.0 ~ 4.5mg / kg. 0.25 ~ 0.5% solution is usually used, and 1.0% solution is used in special cases.
2. Antiarrhythmia (1) Commonly used amount: Intravenous injection of 1 ~ 1.5mg / kg body weight (usually 50 ~ 100mg) as the first load of intravenous injection for 2 ~ 3 minutes, if necessary, repeat intravenous injection 1 ~ 5 minutes later 2 times, but the total amount within 1 hour should not exceed 300mg. Intravenous infusion is generally administered with 5% glucose injection solution at a concentration of 1 ~ 4mg / ml or infusion pump. After using the load, it can be maintained by intravenous drip at a rate of 1 to 4 mg per minute, or intravenously at a rate of 0.115 to 0.03 mg / kg body weight per minute. Elderly people, heart failure, cardiogenic shock, decreased liver blood flow, liver or kidney dysfunction should reduce the amount, 0.5 ~ 1 mg intravenously per minute. That is, intravenous infusion of 0.1% solution of this product can be used, not more than 100mg per hour.
(2) Extreme: 4.5 mg / kg body weight (or 300 mg) within 1 hour of intravenous injection. The maximum maintenance amount is 4 mg per minute.

Adverse reactions of lidocaine hydrochloride injection

(1) This product can act on the central nervous system and cause adverse reactions such as drowsiness, paresthesia, muscle tremor, convulsions and coma, and respiratory depression.
(2) Can cause hypotension and bradycardia. Excessive blood concentration can cause slow atrial conduction velocity, atrioventricular block, and inhibit myocardial contractility and decreased cardiac output.

Contraindications of lidocaine hydrochloride injection

(1) Those who are allergic to local anesthetics are prohibited;
(2) Intravenous disabling in patients with Alzheimer's syndrome (acute cardiogenic ischemic syndrome), preexcitation syndrome, and severe cardiac block (including sinoatrial, atrioventricular, and ventricular block)

Precautions for lidocaine hydrochloride injection

(1) For non-intravenous administration, prevent blood vessels from entering by mistake and pay attention to the diagnosis and treatment of local anesthetic poisoning symptoms.
(2) During the medication, pay attention to check blood pressure, monitor the ECG, and provide rescue equipment; if the PR interval of the ECG is extended or the QRS wave is widened, those who have other arrhythmia or the original arrhythmia should be discontinued immediately.

Lidocaine hydrochloride injection for pregnant and lactating women

This product can penetrate the placenta, and binds to fetal protein higher than adults. Pregnant women can cause fetal bradycardia or tachycardia after administration, and can also cause neonatal methemoglobinemia. Should be used with caution.

Lidocaine Hydrochloride Injection for Children

Medication in neonates can cause poisoning. Premature babies have a longer half-life (3.16 hours: 1.8 hours) than normal infants, so they should be used with caution in newborns and premature babies.

Lidocaine Hydrochloride Injection for Elderly

The dosage for the elderly should be adjusted according to the needs and tolerability, and the dosage for patients> 70 years old should be halved.

Lidocaine Hydrochloride Injection Drug Interactions

(1) Combined with cimetidine and beta receptor blockers such as propranolol, metoprolol and naldolol, lidocaine is inhibited by liver metabolism and lidocaine blood concentration increases, Adverse reactions of the heart and nervous system can occur. The dose of lidocaine should be adjusted, and the blood concentration of lidocaine should be monitored and monitored by electrocardiogram.
(2) Compatibility with the following drugs is contraindicated: amphotericin B, ampicillin, mesopital, sulfadiazine.

Lidocaine Hydrochloride Injection Overdose

Excessive amounts can cause convulsions and cardiac arrest.

Pharmacology and Toxicology of Lidocaine Hydrochloride Injection

This product is an amide local anesthetic. After blood absorption or intravenous administration, it has obvious excitement and inhibitory biphasic effect on the central nervous system, and there can be no pioneering excitement. When the blood concentration is low, analgesia, sleepiness, and pain threshold increase; with the dose Increased, the effect or toxicity is enhanced, anticonvulsant effect at sub-toxic plasma concentration; convulsions can occur when the plasma concentration exceeds 5ug / ml. At low doses, this product can promote K ⁺ efflux in myocardial cells and reduce myocardial autonomy, and has anti-ventricular arrhythmia; at the therapeutic dose, it can affect the electrical activity of myocardial cells, atrioventricular conduction and myocardial contraction. No significant effect; further increase in blood concentration can cause slowing of cardiac conduction velocity, atrioventricular block, inhibit myocardial contractility and decrease cardiac output.

Pharmacokinetics of Lidocaine Hydrochloride Injection

After injection, the tissue is distributed quickly and widely, and can penetrate the blood-brain barrier and placenta. This product has strong anesthesia, rapid onset of action, and strong dispersive power. It takes about 2 hours to eliminate the drug from the local area. Adding epinephrine can prolong its action time. Most are first degraded by liver microenzyme to deethyl intermediate metabolite monoethylglycinamide xylene which still has local anesthesia. The toxicity is increased, and then hydrolyzed by amidase and excreted by urine. About 10% of the amount is in the original form. Excreted, a small amount appears in the bile.

Storage of lidocaine hydrochloride injection

Keep tightly closed.

Lidocaine Hydrochloride Injection Packaging

Polyethylene ampoules for injection, 5ml, 10ml per bottle.

Validity of Lidocaine Hydrochloride Injection

24 months

Lidocaine Hydrochloride Injection Standard

The second edition of the Chinese Pharmacopoeia 2010 and the State Food and Drug Administration Standard YBH15192006

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