Lidocaine With Epinephrine Where Not to Use?

April 10, 2023

Where Not To Use?

Lidocaine With Epinephrine Is a Local Anesthetic And Antiarrhythmic
The anesthetic activity of lidocaine is due to its ability to decrease permeability of sodium ions, block induction and conduction of nerve impulses. It also acts as a vasoconstrictor.

It is used for regional anesthesia, epidural anesthesia and as a topical anesthetic. It is administered intravenously or locally by infiltration techniques (such as percutaneous injection) and peripheral nerve block.

Intravenous regional anesthesia: 1/2% with epinephrine, 1% with epinephrine or 2% with epinephrine is the usual dose associated with an IV regional anesthesia of 45 to 60 minutes duration depending on the type and age of the patient. For spinal anesthesia, the typical dose is 5% lidocaine infused with glucose over 45 to 90 minutes.

Spinal Anesthesia: Patients with pre-existing CNS disorders such as poliomyelitis, pernicious anemia, paralysis from nerve injuries or syphilis should receive spinal anesthesia with caution.

During spinal anesthesia, the drug may accumulate in the central nervous system and produce excitatory and/or depressant CNS manifestations, including headache, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred vision, vomiting, paresthesia, shivering or somnolence.

In general, the use of lidocaine with epinephrine is contraindicated in patients taking tricyclic antidepressants. It is also contraindicated in patients with hypertension and in the presence of convulsions, cardiovascular depression or a prolonged PR interval.

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