Lignocaine Hydrochloride Injection

Generic Name: Lignocaine hydrochloride
Product Name: Lignocaine Hydrochloride Injection

Indication

This drug is used in the treatment of life threatening ventricular arrhythmias, including those associated with heart attacks. It is also used for anaesthesia, either local, regional, or general.

Action

Lignocaine hydrochloride is used to treat disturbances in the heart’s rhythm. The pumping action of the heart is controlled by electrical impulses that are under the control of the nervous system. If the pumping action of the heart is seriously disturbed, this affects the ability of the heart to pump blood effectively around the body. Lignocaine hydrochloride acts by decreasing the sensitivity of heart muscle to electrical impulses. This slows the conduction of electrical signals in the heart muscle, which in turn, helps to restore a regular heart rhythm. This enables the heart to pump blood effectively around the body.

Dose advice

Patients with compromised cardiac function (e.g. congestive heart failure, cardiogenic shock) may require smaller bolus doses.Intravenous infusion is indicated in patients in whom arrhythmia tends to recur after a single injection, and who are not eligible for oral antiarrhythmic therapy.

Local Anaesthesia:

• the lowest dose needed to provide effective anaesthesia should be used, and this varies depending upon area of infiltration.
• injection should be made slowly and with frequent aspiration to guard against intravascular injection, which may produce toxic effects.

Adults:

• the dose should be no greater than 200 mg.
• for spinal anaesthesia, the dose should be no greater than 100 mg.

Children:

• the dose should not exceed 3mg/kg

Intravenous Use in Cardiac Arrhythmias:

Adults:

• the usual dose is lignocaine 50 to 100 mg administered intravenously under ECG monitoring. The dose may be injected at a rate of approximately 25 to 50 mg (2.5 to 5.0 mL of the lignocaine 1% solution or 1.25 to 2.5 mL of the 2% solution) per minute.
• if the initial dose of 50 to 100 mg does not produce the desired response, a second dose may be given after five minutes. No more than 200 to 300 mg of lignocaine should be administered during a one hour period.
• intravenous infusions of lignocaine may be administered at a rate of 1 to 4 mg/minute (20 to 50 mcg/kg/minute). Intravenous infusions must be given under ECG monitoring to avoid potential overdosage and toxicity. The infusion should be terminated as soon as the patient’s cardiac rhythm appears to be stable or at the earliest signs of toxicity.

Children:

• A suggested paediatric dose is a loading dose of lignocaine 0.5 to 1 mg/kg repeated if necessary up to 3 to 5 mg/kg, followed by continuous infusions of 10 to 50 microgram/kg/minute.

Elderly:

• dose may need to be adjusted depending on age and comorbidities.

Schedule

S4

Common side effects

This type of medication can sometimes produce toxic effects such as:

• lightheadedness
• drowsiness
• dizziness
• apprehension
• euphoria
• tinnitus
• blurred or double vision
• nystagmus
• vomiting
• sensations of heat
• cold or numbness
• twitching and tremors
• disorientation
• confusion
• psychosis
• nervousness
• agitation
• nausea
• difficulty swallowing
• dyspnoea
• slurred speech

Uncommon side effects

See above.

References

1. AMH Pty Ltd. Lignocaine. Australian Medicines Handbook: July, 2005.
2. MIMS Pty Ltd. Lignocaine Hydrochloride Injection. Mims Online. Available from: [URL Link]

For further information talk to your doctor.