Lidocaine is a local anesthetic with an amide structure, well-known in surgery, urology, orthopedics, gynecology and various diagnostic procedures. How does lidocaine work? What is its dosage and side effects?
Action of lidocaine
It inhibits the conduction of stimuli in nerve fibers by blocking sodium channels in the membranes of nerve cells. Surface anesthetics with lidocaine diffuse across the mucosal epithelium and reach pain receptors located in the submucosa.
They cause local exclusion of pain sensation on the mucosa (e.g. in the mouth), the surface of wounds and the skin. Lidocaine also inhibits bioelectric activity in depolarized heart muscle, demonstrating anti-arrhythmic properties.
Indications for the use of lidocaine
The most important application is regional anesthesia:
- seed,
- blockages of nerves, nerve trunks and nerve plexuses,
- subarachnoid,
- epidural.
Due to its anti-arrhythmic properties, lidocaine is also administered in ventricular arrhythmias (premature ventricular contractions, ventricular tachycardia), especially in the course of acute myocardial infarction or after an overdose of cardiac glycosides.
Contraindications to the use of lidocaine
Hypersensitivity to amide local anesthetics.
Available preparations
Lidocaine is available as a solution for injection, but also as a gel and an aerosol.
Lidocaine dosage
The product for injection can be used intravenously, infiltration, spinal and epidural. Lidocaine, like other local anesthetics, should be administered slowly after aspiration has been performed to avoid unintentional intravascular injection.
Lidocaine anesthesia should only be performed by physicians who are well acquainted with the technique of anesthesia and trained in the diagnosis and treatment of the consequences of an overdose of lidocaine.
Side effects of lidocaine
Side effects of Lidocaine are usually the result of over-concentration in body fluids, either from an overdose or incorrect injection technique.
Very rarelyappear:
- hypersensitivity reactions (usually skin changes, edema),
- no feeling,
- motor dysfunction
- or electrocution.
With unknown frequency it was noted:
- metallic taste in the mouth,
- feeling lightheaded,
- arousal,
- anxiety,
- muscle tremors,
- sleepiness,
- disturbance of consciousness,
- bradycardia,
- hypotension
- and breathing problems.
Lidocaine administered topically may cause allergic reactions and, when absorbed, also systemic reactions.
Interaction with other medicinal products
Cimetidine, beta-blockers, norepinephrine, inhalation anesthetics inhibit the metabolism of lidocaine by reducing hepatic flow, leading to an increase in serum drug concentration.
Barbiturates, rifampicin, phenytoin accelerate the metabolism of lidocaine by activating microsomal enzymes in the liver.
Lidocaine enhances the effect of medication relaxant striated muscles. Concomitant, therapeutically justified use of lidocaine with other antiarrhythmic drugs may increase its undesirable effects.
Effect on pregnancy and lactation
Animal studies did not show any teratogenic effects of lidocaine. However, there have not been sufficiently large, well-controlled studies in pregnant women.
Since lidocaine is excreted in breast milk, caution should be exercised when using breastfeeding women.
Effects on the ability to drive and use machines
The effects of lidocaine on the ability to drive and use machines depend on the type of surgery performed and the amount of lidocaine used.
After anesthesia with lidocaine, the patient should not drive or operate vehicles or machines for at least 24 hours after the end of the procedure.
Lidocaine storage
The drug should be stored in accordance with the manufacturer's recommendations, it should be protected from light and must not be frozen.