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Lidocaine hydrochloride is a local anesthetic that blocks the generation and transmission of nerve impulses. In addition, Lidocaine also has antiarrhythmic effects by blocking Na + channels, used intravenously to treat ventricular arrhythmias.
1. What is lidocaine hydrochloride?
Lidocaine hydrochloride is a local anesthetic and has a medium duration of action. Local anesthetic by blocking the generation and conduction of nerve impulses by reducing the permeability of nerve cell membranes to sodium ions. Lidocaine is now widely used because of its fast, strong anesthetic ability and longer duration of action than procaine of the same concentration. Lidocaine is commonly used in patients who are sensitive to ester-type local anesthetics. In addition, Lidocaine is also an antiarrhythmic drug, thanks to its Na + channel blocking effect, used intravenously to treat ventricular arrhythmias. Lidocaine reduces the risk of ventricular fibrillation in patients with suspected myocardial infarction.
2. Indications of the drug Lidocaine hydrochloride
Lidocaine is indicated for use in the following cases:
Local anesthetic mucosa before examination, endoscopy, device placement, or other procedures and helps relieve pain in many diseases. Layeral anesthesia and nerve block anesthesia include peripheral nerve block, sympathomimetic, sacral, epidural, and spinal anesthesia. Acute treatment of ventricular arrhythmias after myocardial infarction or during cardiac engineering procedures such as cardiac surgery or cardiac catheterization. Treatment of ventricular extrasystoles in myocardial infarction, treatment of ventricular tachycardia and ventricular fibrillation.
3. Contraindications of Lidocaine
Lidocaine is contraindicated in the following cases:
Hypersensitivity to Amid group anesthetics. Patients with Adams-Stokes syndrome or with severe sinus-atrial dysfunction, severe myocardial failure, all-degree atrioventricular block or intraventricular block (without pacemaker). Patients with porphyria.
4. Lidocaine side effects
When using Lidocaine, patients may experience side effects including:
Common, ADR > 1/100
Cardiovascular: Hypotension, flushing, thrombophlebitis. Central nervous system: Shivering, headache when changing position. Uncommon, 1/1000 < ADR < 1/100
Cardiovascular: Arrhythmia, cardiovascular collapse, cardiac arrest, circulatory shock. Respiratory: Shortness of breath, bronchospasm, respiratory failure. Central nervous system: Lethargy, coma, slurred speech, convulsions, euphoria, hallucinations, agitation, anxiety, fear, paresthesia. Gastrointestinal: Nausea, vomiting. Hypersensitivity: Anaphylactic reactions, hypersensitivity. Musculoskeletal: Tremor, asthenia. Skin: Itching, rash, skin edema, numbness around the lips and tip of the tongue. Other: Blurred vision, double vision, tinnitus.
5. Notes when using Lidocaine
Lidocaine should be used with caution in patients with severe liver dysfunction as it may increase the risk of Lidocaine toxicity. Do not use Lidocaine products containing preservatives for spinal anesthesia, epidural anesthesia of the sacral cavity. It should be used with caution in patients with heart failure, severe respiratory failure, severe hypoxia, hypovolemia or shock, incomplete heart block, bradycardia and atrial fibrillation. Methemoglobinemia: Methemoglobinemia has been reported in patients receiving local anesthetics. This condition should be treated immediately with discontinuation of anesthetics and other oxidants. Patients with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methemoglobinemia, heart or lung damage, or neonates <6 months are at increased risk and should be closely monitored for signs and symptoms Symptoms of methemoglobinemia such as cyanosis of the skin, headache, tachycardia, dyspnea, dizziness, and fatigue. Severely ill or debilitated patients should be used with caution because of the potential for systemic toxicity. Lidocaine should not be injected into inflamed or infected tissues and traumatized urethra because it can be rapidly absorbed and cause a systemic rather than local reaction. Pregnancy: Lidocaine has been widely used in surgery for pregnant patients with no reported adverse effects on the mother and fetus. Lactation: Lidocaine is distributed in breast milk in very small amounts, so there is no risk of harmful effects to the nursing infant.
6. Lidocaine drug interactions
Lidocaine hydrochloride when used concurrently with some drugs can reduce effectiveness or increase toxicity. Therefore, it is best for patients to inform their doctor or pharmacist of all medicines, herbs, and supplements they are using for advice. Here are some notable drug interactions when using Lidocaine:
Combining Adrenalin with Lidocaine may reduce the rate of absorption and toxicity, thereby prolonging the duration of action of Lidocaine. Other amide-derivative anesthetics with antiarrhythmic effects increase myotoxicity due to their additive cardiac effects. Note the risk of overdose when using lidocaine system or local anesthetic injection at the same time as topical application of lidocaine on mucous membranes, especially when used in large amounts, repeatedly and used in the mouth and throat. Beta-blockers: Concomitant use of beta-blockers with Lidocaine may slow the metabolism of Lidocaine by reducing hepatic blood flow, leading to an increased risk of Lidocaine toxicity. Cimetidine may inhibit the metabolism of lidocaine in the liver and increase the risk of toxicity. Concomitant use of Succinylcholine with Lidocaine may potentiate the effects of Succinylcholine. The article has provided an overview of the drug Lidocaine hydrochloride. To ensure the safety of taking the drug, patients should consult a healthcare professional before taking
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