title: Lignocaine for local anaesthetic, cardiac arrhythmia
text: |
  Lignocaine for local anaesthetic, cardiac arrhythmia
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  bet | 337/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Revision Date : 01/03/2021
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  Approved: DT, TC, KOH
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  Indication :
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  Ventricular arrythmias
  Local anaesthesia
  Topical anaesthesia
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  Dose :
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  Ventricular arrythmias: 1 mg/kg (0.1 ml/kg of 1%) loading dose. Follow within 15 minutes with an infusion of 10-50 microg/kg/min otherwise repeat loading dose if infusion delayed >15 minutes.
  Local anaesthesia: maximum dose without adrenaline 5 mg/kg
  Surface (Topical) anaesthesia: of mouth, throat and upper GI tract: mixture up to 3 mg (0.15 ml)/kg/dose
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  Interval :
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  Loading dose can be repeated within 15 minutes if infusion not started
  Local anaesthesia: do not repeat
  Topical: do not repeat within 2 hours
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  Route :
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  IV over 2 minutes
  Local infiltration
  Topical, can dab onto severe mouth ulcers before feeds
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  Total Daily Dose :
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  1) As per requirements for Arrhythmias
  2 and 3) As per interval above
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  Comments :
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  Can give 1% undiluted or dilute with NS. Excessive topical use in mouth can paralyse gag reflex.
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  Supplied as :
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  1% ampoules (10mg/ml)
  Mixture: 2% Xylocaine Viscous
  Gel: 2%
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  Dilution :
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  For IV infusion using 1% lignocaine solution (10mg/ml) take 3 ml multiplied by weight of the patient in kg and make up to 50 ml with NS. 1 ml/hr = 10 microg/kg/min. DO NOT USE THIS DILUTION FOR SEIZURE PROTOCOL
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  Stability :
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  Discard any remaining solution from ampoules – intended for single use only.
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  Storage :
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  Room temperature.
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  Incompatibility :
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  Thiopentone, Phenytoin, Ampicillin, Acyclovir, Phenobarbitone
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  Compatibility:
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  5% Dextrose, N/2 Saline, NS, aminophylline, calcium gluconate, digoxin, dobutamine, dopamine, adrenaline, frusemide, heparin, hydrocortisone, insulin, nitroglycerine, KCl, ranitidine.
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  Serum Levels :
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  Lignocaine levels are not performed at TCH. If required they can be sent away to RNS, ring specimen referrals on 42845. Levels above 9mg/L are associated with cardiac toxicity in adults, but there is little information regarding levels in neonates.
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  Original version Date: 2014
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  Author: DT
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  Current Version number: 2
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  Version Date: 1-3-2021
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  Risk Rating: Low
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  Due for Review: 1-3-2025
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  Approved by: DTC
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  Approval Date: TBA
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