Category:

• Local anesthetic

Description:

• Local anesthetic

Indications:

• Nerve block, caudal anesthesia, epidural anesthesia

• Pain relief, paracervical block in obstetrics, transvaginal block

• Soft tissue infiltration anesthesia, anesthesia of dental procedures

Contraindications:

• Heart block (large doses)

• Septicemia (spinal anesthesia)

Precautions:

• Pregnancy category C

• Hepatic disease, use in head and neck, children, inflammation

• Sepsis, elderly, neurologic disease, spinal deformaties

• Impaired cardiovascular function, renal disease

• Hypertension (epidural and caudal anesthesia)

Adverse Reactions (Side Effects):

• CNS: anxiety, disorientation, loss of consciousness, seizures, shivers, tremors

• CV: bradycardia, cardiac arrest, dysrhythmias, fetal bradycardia, myocardial depression, hypotension, hypertension

• RESP: anaphylaxis, respiratory arrest

• SKIN: allergic reactions, burning, skin discoloration at injection site, tissue necrosis

Dosage:

Administered via injection

• Adult:  Dose varies with type of procedure, degree of anesthesia required, and individual response; max amount given per procedure should not exceed 400mg; total dose per 24 hours should not exceed 1g

  • Nerve block: 

    • 1% or 2% solution

  • Paracervical block: 

    • 1% solution

  • Transvaginal block: 

    • 1% solution

  • Caudal and epidural block: 

    • 1%, 1.5%, or 2% solution

  • Infiltration: 

    • 1% solution

  • Dental procedures: 

    • 3% solution