Dextrose + Lidocaine Hydrochloride

Dextrose + Lidocaine Hydrochloride is used for: Ventricular fibrillation, Ventricular tachycardia, Arrhythmias, Spinal anesthesia, Epidural anesthesia, Haemorrhoids, Surface anesthesia, Regional anesthesia, Cataract surgery, Sympathetic nerve block, Peripheral nerve block, Perianal pain and itching

Adult: Mouth/Throat Surface anesth For pain: As 2% soln: 300 mg, not more often than 3 hrly. Before procedures in the mouth and throat: As 4% soln: 40-300 mg. For dentistry and otorhinolaryngology procedures: As 10% soln: 10-50 mg. For laryngotracheal anesth: As 4% soln: 160 mg as a single dose. IV Ventricular arrhythmias As HCl: In advanced cardiac life support: 1-1.5 mg/kg, repeat if needed. Max total: 3 mg/kg. In more stable patients: 50-100 mg. May repeat once or twice if needed, up to a max of 200-300 mg in 1 hr, then 1-4 mg/min via continuous infusion. Regional anesth 50-300 mg (0.5% soln w/o adrenaline). Max: 4 mg/dose. IM Ventricular arrhythmia emergency 300 mg, repeat after 60-90 mins if needed. Epidural Epidural anesth 2-3 mL soln for each dermatome to be anaesthesized. Lumbar epidural: 250-300 mg (1% soln) for analgesia and 225-300 mg (1.5% soln) or 200-300 mg (2% soln) for anesth and thoracic epidural: 200-300 mg (1% soln). In obstetric caudal analgesia, up to 300 mg (0.5 or 1% soln). For surgical caudal analgesia: 225-300 mg (1.5% soln). For continuous epidural anaesthesia, not to repeat max doses more often than 1.5 hrly. Parenteral Sympathetic nerve block As 1% soln: 50 mg for cervical block; 50-100 mg for lumbar block. Peripheral nerve block Brachial plexus block: 225-300 mg (1.5% soln). Intercostal nerve block: 30 mg (1% soln). Paracervical block: 100 mg (1% soln) on each side, repeated not more often than 1.5 hrly. Paravertebral block: 30-50 mg (1% soln). Pudendal block: 100 mg (1% soln) on each side. Retrobulbar block: 120-200 mg (4% soln). Percutaneous infiltration anesth 5-300 mg (0.5 or 1% soln). Intraspinal Spinal anesth Normal vag delivery: 50 mg (5% hyperbaric soln) or 9-15 mg (1.5% hyperbaric soln). Caesarean operation: Up to 75 mg (5% hyperbaric soln). Other surgical procedures: 75-100 mg. Ophth Pupil dilatation during phacoemulsification cataract surgery As 1% soln: (often used w/ phenylephrine and cyclopentolate): Inject into anterior chamber of the eye at the start of the procedure. Surface anesth As 4% soln w/ fluorescein : 1 drops if needed.

Hypovolaemia; heart block or other conduction disturbances.

Hepatic or renal impairment; CHF and following cardiac surgery; bradycardia; respiratory depression; porphyria; elderly or debilitated patients; pregnancy.

May increase serum levels w/ cimetidine and propranolol. Increased risk of cardiac depression w/ beta-blockers and other antiarrhythmics. Additive cardiac effects w/ IV phenytoin. Hypokalaemia caused by acetazolamide, loop diuretics and thiazides may antagonise effect of lidocaine. Dose requirements may be increased w/ long-term use of phenytoin and other enzyme-inducers.

Side effects of Dextrose + Lidocaine Hydrochloride : Dizziness, paraesthesia, drowsiness, confusion, respiratory depression and convulsions. Potentially Fatal: Hypotension and bradycardia leading to cardiac arrest; anaphylaxis.

Lidocaine is an amide type local anaesth. It stabilises the neuronal membrane and inhibits Na ion movements, which are necessary for conduction of impulses. In the heart, lidocaine reduces depolarisation of the ventricles during diastole and automaticity in the His-Purkinje system. Duration of action potential and effective refractory period are also reduced. Dextrose is a monosaccharide that is used as a source of calories and water for hydration. It helps to reduce loss of body protein and nitrogen. It also promotes glycogen deposition in the liver.