Lidocaine, also known as lignocaine, is a numbing medication used to numb tissues of body and to treat ventricular tachycardia. Lidocaine can also be used for nerve blocks. 5 percent of lidocaine is approved by FDA to be used a a numbing agent.
Lidocaine mixed with a small amount of epinephrine can be used as larger doses to be used as numbing and to make its effect last longer. When used in the form of injectable, it typically begins working within a few minutes and lasts for about three to four hours. Lidocaine can also be applied directly to the skin for numbing.
Lidocaine was discovered in 1946 and came in the market for sale in 1948. It is on the WHO Model List of Essential Medicines as the most important medications needed in a basic healthcare system. Lidocaine is available as a generic medication and is not very expensive.
Complications
Common side effects of lidocaine with intravenous use include dizziness, sleepiness, muscle twitching, changes in vision, confusion, tingling, and vomiting. Excessive usage can cause low blood pressure and an irregular heart rate.
Concerns are also there when it comes to injecting it into a joint. This can cause problems with the cartilage. A lower dose may be required in those with liver problems. Generally, it is safe to use in those allergic to tetra Caine or benzocaine. It works by blocking sodium channels and decreasing the rate of contractions of the heart. When used locally as a numbing agent, local neurons cannot signal the brain.
Indications and Usage for Lidocaine
Lidocaine hydrochloride injection is indicated for production of local or regional anesthesia by infiltration techniques such as percutaneous injection and intravenous regional anesthesia by peripheral nerve block techniques such as brachial plexus and intercostal and by central neural techniques such as lumbar and caudal epidural blocks, when the accepted procedures for these techniques as described in standard textbooks are observed.
Use in the Head and Neck Area
Small doses of local anesthetics injected into the head and neck area that includes retrobulbar, dental and stellate ganglion blocks can produce adverse reactions similar to systemic toxicity seen with unintentional intravascular injections of greater doses. Convulsions, respiratory depression, respiratory arrest, confusion, and cardiovascular stimulation or depression have been stated. These reactions may be due to the intra-arterial injection of the local anesthetic with retrograde flow to the cerebral circulation. Patients who receive these blocks should have their respiration and circulation examined and constantly observed. Resuscitative equipment for treating adverse reactions should be immediately available. It is highly recommended to take only the prescribed amount of dosage and not more.
Labor and Delivery
Local anesthetics rapidly flow into the placenta and when used for epidural, pudendal or caudal block anesthesia, can lead to various degrees of maternal, fetal and neonatal toxicity. The potential for its toxicity greatly depends upon the procedure performed, the amount and type of drug used, and the technique of drug administration. Adverse reactions in the parturient, fetus and neonate involve alterations of the central nervous system, peripheral vascular tone and cardiac function.
Regional anesthesia has been resulted in maternal hypotension. Local anesthetics produce vasodilation by blocking sympathetic nerves. Raising the patient’s legs and positioning her on her left side will help prevent decreases in blood pressure. The fetal heart rate also should be monitored continuously, and electronic fetal monitoring is highly advisable.
Epidural, spinal, paracervical, or pudendal anesthesia may change the forces of parturition through changes in uterine contractility or maternal expulsive efforts. In one study, paracervical block anesthesia was associated with a decrease in the mean duration of first stage labor and facilitation of cervical dilation. But, spinal and epidural anesthesia have also been stated to extend the second stage of labor by removing the parturient reflex urge to tolerate or by interfering with motor function. The use of obstetrical anesthesia may increase the need for forceps assistance.
The conclusion is lidocaine is a great numbing agent if taken in right quantity as recommended by the doctor to avoid complications.
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