Lidocaine hydrochloride (lidocaini hydrochloridum)

LIDOKAINA HYDROCHLORIDE (Lidocaini hydrochloridum).
  Dietilamino 2--2 ', 6'- atsetoksilidida hydrochloride, or a-diethylamino-2, 6-dimetilatsetanilida hydrochloride, Monohydrate.
     Synonyms : Ksikain, Ksilokain, Lidestin, Acetoxyline, Alocaine, Anestacon, Anestecain, Astracaine, Dolicaine, Dulcicaine, Esracaine, Fastocaine, Leostesin, Lidestin, Lidocaine, Lidocard, Lidocaton, Lignocain, Maricain, Nulicaine, Octocaine, Remicaine, Solcain, Stericaine, Xycain, Xylesin, Xylocain, Xylocard, Xylocitin, Xyloton, Xylotox and others.
     White or almost white crystalline powder. Very easily soluble in water, soluble in alcohol.
     On the chemical structure of the derivatives ksilokain atsetanilida. Unlike novocaine, it is not difficult ether, slowly metabolised in the body and has more length than novocaine. Because of that, in its metabolism in the body is not education parameters benzaminic acid, it is not having antisulfanilamidnogo action and can be used in patients receiving sulfanilamidnye drugs. This same group of local anesthetics applied trimekain. Close to them on the structure piromekain.
     Along with lidocaine mestnoanesteziruyuschey activity has expressed complications properties.
     Lots-strong mestnoanesteziruyuschee funds, causing all kinds of local anaesthesia : terminal, infiltration, and conductors. Compared with novocaine, it is faster, stronger and longer. Relative lidocaine toxicity depends on the concentration of the solution. In low concentrations (0.5%), it has not significantly different toxicity of novocaine; With increasing concentrations (1% and 2%) increased toxicity (40-50%).
     For irrigated anesthesia used 0,125%, 0.25% and 0.5% solutions; Anesthesia for peripheral nerves, 1% and 2% solutions; Epidural anesthesia for 1% to 2% solutions; Spinal anesthesia for 2% solution.
     The total number of mortar and lidocaine dose depends on the type of anesthesia and surgical intervention. With increasing concentration of total dose of lidocaine reduces.
     In applying 0.125% solution of the maximum number of 1600 mL of solution and the total dose of lidocaine hydrochloride, 2,000 mg (2 g); In applying the 0.25% solution of 800 ml, and 2000 mg (2 g); 0.5% solution Total 80 ml, with a total dose of 400 mg; 1% and 2% solutions of the total number of 40 and 20 ml respectively, while the total dose of 400 mg (0.4 g).
     For lubricating mucous membranes (in tracheal intubations, bronhoezofagoskopii, removing polyps, mishaps gaymorovoy floor, etc.) using 1 - 2% solutions, less 5% solution of no more than 20 ml.
     Solutions lidocaine compatible with adrenaline; Adds ex tempore 1% solution via gidrohlorila 1 drop of 10 ml ksikaina, but not more than 5 drops of the solution to everything.
     The use of lidocaine as a means antiaritmicheskogo mainly due to his stabilizing influence on the cell membrane attack (act intended to several other local anesthetics, adrenoblokatoram and other drugs that have antiaritmichesky effect). He blocks slow currents of sodium ions in cells attack and can therefore suppress automatic Cumulative impulsoobrazovaniya pockets. This feature conductivity not oppressed. Like other local anaesthetics, it contributes potassium ions out of cells attack and speeds up repolyarizatsii cellular membranes, shortened the length of the building and effective refrakternogo period. On mechanism of lidocaine (like other local anaesthetics) differs from complications hinidinopodobnyh substances (see Antiaritmicheskie drugs).
     Testimony to use lidocaine as a means antiaritmicheskogo ventricular arrythmia and ventricular tachycardia, especially in the acute phase of myocardial infarction; Prevention fibrillyatsy Poly with a severe heart attack.
     In supraventrikulyarnyh keep lidocaine is not nominated (because of the inefficiency and risk increases with cuts zheludochkovyh fibrillation and saturated predserdy).
     Enter lidocaine as a means of intravenous antiaritmicheskogo first struyno (within 3 to 4 minutes) at an average dose of 80 mg (50-100 mg), and then continue to be drip averaging 2 mg per minute. Infusion duration depends on the patient's condition and results of the drug. For Infusion grow 2% (ampulny) lidocaine solution isotonic sodium chloride solution (for a solution containing 2 mg in 1 ml, 2 ml grow 6% solution of lidocaine 60 ml isotonic sodium chloride solution). Total solution imposed for the day, at about 1200 ml. Enter to begin intravenous struyno 80 mg and 400 mg intramuscularly at the same time (4 ml 10% solution); Then every three-hour intramuscular injection of 200-400 mg (2 to 4 ml of 10% solution).
     While the use of epidural lidocaine to reduce pain and edema departments in acute myocardial infarction period.
     Lots usually well, local irritation is. With the rapid preparation in current blood could experience a reduction in AD and collapse; Anti-hypertensive effect is the reduction of ephedrine or other sosudosuzhivayuschih funds.
     Lots weakness is not suitable for sinusovogo node in patients older atrioventrikulyarnoy blockade II-III degree (except when a probe to stimulate Poly), a sharp aetiology, kardiogennom shock, severe disorders of the liver, increased sensitivity to individual lidocaine.
     Product : 1% solution in 10 mL ampoules; 2% solution in ampoules of 2 and 10 ml; 10% solution in 2 ml ampoules.
     Storage : List B. In the dark places :
     Abroad, lidocaine (Lidestin) was also issued in the form of aerosol for local anesthesia (surface) in dental, eye, the surgery - a change of dressing, opening abscesses, etc. aerosol container contains 750 doses of 10 mg lidocaine. Number of drug spread depends on the surface to be pain. In adults should not exceed 200 mg dose, ie 20 dissipation; Children-correspondingly less.
     It should not be allowed into aerosol in the eye.

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