• Ventricular arrythmias
  • DO NOT USE THIS DILUTION FOR SEIZURE PROTOCOL
  • Lignocaine for local anaesthetic, cardiac arrhythmia




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    Lignocaine for local anaesthetic, cardiac arrhythmia


    Revision Date : 01/03/2021

    Approved: DT, TC, KOH




    Indication :

    1. Ventricular arrythmias

    2. Local anaesthesia

    3. Topical anaesthesia

    Dose :

    1. Ventricular arrythmias: 1 mg/kg (0.1 ml/kg of 1%) loading dose. Follow within 15 minutes with an infusion of 10-50 microg/kg/min otherwise repeat loading dose if infusion delayed >15 minutes.

    2. Local anaesthesia: maximum dose without adrenaline 5 mg/kg

    3. Surface (Topical) anaesthesia: of mouth, throat and upper GI tract: mixture up to 3 mg (0.15 ml)/kg/dose

    Interval :

    1. Loading dose can be repeated within 15 minutes if infusion not started

    2. Local anaesthesia: do not repeat

    3. Topical: do not repeat within 2 hours

    Route :

    1. IV over 2 minutes

    2. Local infiltration

    3. Topical, can dab onto severe mouth ulcers before feeds

    Total Daily Dose :

    1) As per requirements for Arrhythmias

    2 and 3) As per interval above



    Comments :

    Can give 1% undiluted or dilute with NS. Excessive topical use in mouth can paralyse gag reflex.

    Supplied as :

    1% ampoules (10mg/ml)

    Mixture: 2% Xylocaine Viscous

    Gel: 2%


    Dilution :

    For IV infusion using 1% lignocaine solution (10mg/ml) take 3 ml multiplied by weight of the patient in kg and make up to 50 ml with NS. 1 ml/hr = 10 microg/kg/min. DO NOT USE THIS DILUTION FOR SEIZURE PROTOCOL

    Stability :

    Discard any remaining solution from ampoules – intended for single use only.

    Storage :

    Room temperature.

    Incompatibility :

    Thiopentone, Phenytoin, Ampicillin, Acyclovir, Phenobarbitone

    Compatibility:

    5% Dextrose, N/2 Saline, NS, aminophylline, calcium gluconate, digoxin, dobutamine, dopamine, adrenaline, frusemide, heparin, hydrocortisone, insulin, nitroglycerine, KCl, ranitidine.

    Serum Levels :

    Lignocaine levels are not performed at TCH. If required they can be sent away to RNS, ring specimen referrals on 42845. Levels above 9mg/L are associated with cardiac toxicity in adults, but there is little information regarding levels in neonates.




    Original version Date: 2014

    Author: DT

    Current Version number: 2

    Version Date: 1-3-2021

    Risk Rating: Low

    Due for Review: 1-3-2025

    Approved by: DTC

    Approval Date: TBA




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    Lignocaine for local anaesthetic, cardiac arrhythmia

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