Lignocaine with Adrenaline

Anaesthetic · Beta-2 agonist/Local anaesthetic

Indications

Inj 2% with adrenaline 1:200,000: Local infiltration anaesthesia; AVS for nerve block. Inj (Dental): As local anaesthesia for use in the dental infiltration anaesthesia and in dental nerve-block technique.

Dosage

Inj 2% with adrenaline 1:200,000: Children: Use lignocaine concentration of 0.5% to 1% (or even more diluted) to decrease possibility of toxicity. Lignocaine dose should not exceed 7 mg/kg/dose; do not repeat within 2 hr. Adults: Dosage varies with the anaesthetic procedure, degree of anaesthesia needed, vascularity of tissue, duration of anaesthesia needed, physical condition of patient. Inj (Dental): Conduction anaesthesia, infiltration anaesthesia: 6 to 40 mg of lignocaine. Oral surgery anaesthesia: 60-100 mg of lignocaine.

Adverse Effects

Dizziness, confusion, convulsions, respiratory depression, cardiac arrest, paraesthesia, bradycardia, BP changes, GI upset, allergic/anaphylactic reactions.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Lignocaine: Complete heart block, hypovolaemia. Precautions: Renal, hepatic impairment, hypertension, severe shock, epilepsy, Myasthaenia gravis, elderly, porphyria, respiratory impairment, partial or complete heart block, cardiac disease, cerebrovascular insufficiency, hyperthyroidism, diabetes, asthma.

Interactions

Cimetidine, antiarrhythmics, diuretics, B blockers, TCADs, MAOIs, oxytocic drugs, phenothiazines, butyrophenones, halothane, enflurane.

Pharmacokinetics

LIGNOCAINE: Onset of action: Single bolus dose: 45-90 seconds. Duration: 10-20 mins. Metabolism: 90% hepatic. Half-life elimination: Biphasic: Prolonged with congestive heart failure, liver disease, shock, severe renal disease; Initial: 7-30 mins; Terminal: Infants, premature: 3.2 hrs, Adults: 1.5-2 hrs. Excretion: Urine (<10% as unchanged drug, approx. 90% as metabolites). ADRENALINE: Onset of action: Bronchodilation: SC: Approx. 5-10 min. Absorption: Orally ingested doses are rapidly metabolized in GI tract and liver. Metabolism: Hepatic. Half-life elimination: IV: <5 min. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

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