XYLOCAINE INJECTION 1% (5ML) [SIN05616P]

Product Info

XYLOCAINE INJECTION 1% (5ML)

[SIN05616P]

INDICATIONS
XYLOCAINE solutions are indicated for the production of local or regional anaesthesia by the following techniques:

• infiltration,

• intravenous regional anaesthesia,

• peripheral nerve block such as intercostal block,

• major plexus block such as brachial plexus block,

• epidural block,

• subarachnoid block.

DOSE AND METHOD OF ADMINISTRATION
The lowest dosage and volume that results in effective anaesthesia should be used and should be based on the status of the patient and the type of regional anaesthesia intended. XYLOCAINE solutions contain no antimicrobial agent and should be used only once and any residue discarded.

Lignocaine should be administered with great caution to patients with impaired cardiovascular function as they may be less able to compensate for functional changes associated with the prolongation of AV conduction produced by these drugs.

Adult
Recommended dosages for XYLOCAINE solutions for various anaesthetic procedures in the average, healthy, 70 kg adult patient.

Note :

1. Recommended doses
   The above suggested concentrations and volumes serve only as a guide. Toxic doses vary widely between patients and toxic effects may occur after any local anaesthetic procedure.

   Careful observation of the patient must therefore be maintained. It is recommended that the dose of lignocaine at any one time should not exceed 3 mg/kg. However, the dose administered must be tailored to the individual patient and procedure, and the maximum doses here quoted should be used as a guide only.

2. Hypotension
   During thoracic, lumbar and caudal epidural anaesthesia, a marked fall in blood pressure and/or intercostal paralysis may be seen, possibly due to the use of excessive doses, improper positioning of the patient or accidental disposition of the anaesthetic within the subarachnoid space. Hypotension and bradycardia may occur as a result of sympathetic blockade.

3. Test dose
   For epidural anaesthesia, a 3–5 mL test dose of a local anaesthetic solution preferably containing up to 15 micrograms of adrenaline should be administered.

   Verbal contact and repeated monitoring of heart rate and blood pressure should be maintained for 5 minutes after the test dose after which, in the absence of signs of subarachnoid or intravascular injection, the main dose may be administered.

   Use of a test dose containing adrenaline may have further advantages in that an intravascular injection of adrenaline will be quickly recognised by an increase in heart rate, usually within about 40 seconds. To detect this, the heart rate and rhythm should be monitored with an electrocardiogram.

   Prior to administration of the total dose, aspiration should be repeated. The main dose should be injected slowly, with continual assessment of the patient. If toxic symptoms or signs occur, the injection should be stopped immediately.

Use in Children
For children, a reduced dosage based on body weight or surface area should be used. The dosage should be calculated for each patient individually and modified in accordance with the physician’s experience and knowledge of the patient.

In order to minimise the possibility of toxic effects, the use of XYLOCAINE 0.5% or 1% solutions is recommended for most anaesthetic procedures involving paediatric patients.

In children, early signs of local anaesthetic toxicity may be difficult to detect in cases where the block is given during general anaesthesia.

Use in Elderly
A reduction in dosage may be necessary for elderly patients especially those with compromised cardiovascular and/or hepatic function.

In epidural anaesthesia, a smaller dose may provide adequate anaesthesia.

With impaired hepatic function
Although lignocaine is metabolised by the liver, dosage reduction for local anaesthesia is probably not warranted. However, caution should be exercised with repeated doses.

With impaired renal function
Impairment of renal function is unlikely to affect lignocaine clearance in the short term (24 hours). However, toxicity due to accumulation may develop with prolonged or repeated administration.

CONTRAINDICATIONS

1. Allergy or hypersensitivity to amide type local anaesthetics or to any excipients. Detection of suspected hypersensitivity by skin testing is of limited value.

2. Local anaesthetics are contraindicated for epidural and spinal anaesthesia in patients with uncorrected hypotension or coagulation disorders or in patients receiving anti-coagulation treatment.

3. Local anaesthetic techniques must not be used when there is inflammation and/or sepsis in the region of the proposed injection and/or in the presence of septicaemia.

4. XYLOCAINE should not be used in patients with Stokes-Adam syndrome, Wolff- Parkinson-White syndrome, or with severe degrees of sinoatrial, atrioventricular, or intraventricular block in the absence of an artificial pacemaker.

5. General contraindications related to epidural anaesthesia, regardless of the local anaesthetic used, should be taken into account.