Jasocaine Injection
Lidocaine (Lignocaine) Hydrochloride
4%
Jayson
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Available as:
Indications
Jasocaine Injection is used for:
Ventricular arrhythmias, Haemorrhoids, Sympathetic nerve block, Peripheral nerve block, Perianal pain and itching, Ventricular fibrillation or ventricular tachycardia, Epidural anaesthesia, Spinal anaesthesia, Regional anaesthesia, Surface anaesthesia, Pupil dilatation
Adult Dose
Intravenous
Ventricular Arrhythmias
1-1.5 mg/kg slow IV bolus over 2-3 minutes
May repeat doses of 0.5-0.75 mg/kg in 5-10 minutes up to 3 mg/kg total
Continuous infusion: 1-4 mg/min IV
Regional Anesthesia (IV)
4 mg/kg
Parenteral
Sympathetic nerve block
Adult: As 1% soln: 50 mg for cervical block or 50-100 mg for lumbar block.
Epidural
Epidural anaesthesia
Adult: 2-3 mL administered for each dermatome to be anaesthesised.
Recommended doses are: Lumbar epidural 250-300 mg (as 1% soln) for analgesia and 225-300 mg (as 1.5% soln) or 200-300 mg (as 2% soln) for anaesth;
for thoracic epidural: 200-300 mg (as 1% soln).
For obstetric caudal analgesia: 200-300 mg (as 1% soln);
for surgical caudal anaesth: 225-300 mg (as 1.5% soln).
For continuous epidural or caudal anaesth, not to repeat max doses more frequently than 1.5 hrly.
Peripheral nerve block
Adult: As 1.5% soln: For brachial plexus block: 225-300 mg.
As 2% soln: For dental nerve block: 20-100 mg.
As 1% soln: For intercostal nerve block: 30 mg; for paracervical block: 100 mg on each side, repeated not more frequently than every 90 min; for paravertebral block: 30-50 mg; for pudendal block: 100 mg on each side.
As 4% soln: For retrobulbar block: 120-200 mg.
Intraspinal
Spinal anaesthesia
Adult: As hyperbaric soln of 1.5% or 5% lidocaine in 7.5% glucose soln.
Normal vaginal delivery: Up to 50 mg (as 5% soln) or 9-15 mg (as 1.5% soln).
Caesarian operation: Up to 75 mg (as 5% soln).
Other surgical procedures: 75-100 mg.
Hepatic impairment: Dosage reduction may be needed.
Child Dose
Ventricular Arrhythmias
Bolus: 0.5-1 mg/kg IV/IO/ET, not to exceed 100 mg; follow with continuous infusion; if delay between bolus and start of infusion is >15 minutes, administer a second bolus q5-10min to 5 mg/kg, THEN
Continuous infusion: 20-50 mcg/kg/min IV
Renal Dose
Administration
IV Preparation
Add 1-2 g of lidocaine hydrochloride to 1 L of D5W making 1-2 mg/mL solution; use (using 5-10 mL of 20% inj soln); may also use 400 mg/100 mL in D5W or 800 mg/100 mL in D5W
8 mg/mL concentrations have been recommended for fluid-restricted pts
Contra Indications
Hypovolaemia; heart block or other conduction disturbances.
Precautions
Hepatic or renal impairment; CHF and following cardiac surgery; bradycardia; respiratory depression; porphyria; elderly or debilitated patients; pregnancy.
Lactation: crosses into breast milk, use caution
Pregnancy-Lactation
Interactions
May increase serum levels w/ cimetidine and propranolol. Increased risk of cardiac depression w/ ?-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.
Adverse Effects
Side effects of Lidocaine (Lignocaine) Hydrochloride :
Common
Cardiovascular: Hypotension
Dermatologic: Edema, erythema at injection site, petechiae, skin irritation
Gastrointestinal: Constipation, Nausea, vomiting
Neurologic: Confusion, dizziness, headache, paresthesia, somnolence, tremor
Other: Irritation symptom, Topical products; ie, erythema, edema
Serious
Cardiovascular: Cardiac arrest, cardiac dysrhythmia
Hematologic: Methemoglobinemia
Neurologic: Seizure
Anaphylactoid reactions
Malignant hyperthermia
Potentially Fatal: Hypotension and bradycardia leading to cardiac arrest; anaphylaxis.
Mechanism of Action
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.
Note
Jasocaine 4% Injection manufactured by Jayson. Its generic name is Lidocaine (Lignocaine) Hydrochloride. Jasocaine is availble in Nepal.
Farmaco Nepal drug index information on Jasocaine Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.