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Lignocaine for local anaesthetic, cardiac arrhythmia
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| bet | 337/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Lignocaine for local anaesthetic, cardiac arrhythmia
Revision Date : 01/03/2021
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Approved: DT, TC, KOH
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Indication :
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Ventricular arrythmias
Local anaesthesia
Topical anaesthesia
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Dose :
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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.
Local anaesthesia: maximum dose without adrenaline 5 mg/kg
Surface (Topical) anaesthesia: of mouth, throat and upper GI tract: mixture up to 3 mg (0.15 ml)/kg/dose
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Interval :
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Loading dose can be repeated within 15 minutes if infusion not started
Local anaesthesia: do not repeat
Topical: do not repeat within 2 hours
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Route :
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IV over 2 minutes
Local infiltration
Topical, can dab onto severe mouth ulcers before feeds
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Total Daily Dose :
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1) As per requirements for Arrhythmias
2 and 3) As per interval above
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Comments :
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Can give 1% undiluted or dilute with NS. Excessive topical use in mouth can paralyse gag reflex.
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Supplied as :
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1% ampoules (10mg/ml)
Mixture: 2% Xylocaine Viscous
Gel: 2%
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Dilution :
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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
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Stability :
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Discard any remaining solution from ampoules – intended for single use only.
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Storage :
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Room temperature.
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Incompatibility :
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Thiopentone, Phenytoin, Ampicillin, Acyclovir, Phenobarbitone
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Compatibility:
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5% Dextrose, N/2 Saline, NS, aminophylline, calcium gluconate, digoxin, dobutamine, dopamine, adrenaline, frusemide, heparin, hydrocortisone, insulin, nitroglycerine, KCl, ranitidine.
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Serum Levels :
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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.
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Original version Date: 2014
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Author: DT
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Current Version number: 2
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Version Date: 1-3-2021
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Risk Rating: Low
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Due for Review: 1-3-2025
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Approved by: DTC
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Approval Date: TBA
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