Medication Description: Lidocaine Hydrochloride (Lidocaini hydrochloridum)
LIDOCAINE HYDROCHLORIDE (Lidocaini hydrochloridum).
2-diethylamino-2 ', 6'-acetoxylide hydrochloride, or a-diethylamino-2, 6-dimethylacetanilide hydrochloride, monohydrate.
Synonyms of Xyca Xycain, Xylesin, Xylocain, Xylocard, Xylocitin, Xyloton, Xylotox, etc.
White or almost white crystalline powder. Very easily soluble in water, soluble in alcohol.
According to the chemical structure, xylocaine refers to acetanilide derivatives. Unlike novocaine, it is not a complex ester, is metabolized more slowly in the body and acts longer than novocaine. Due to the fact that during its metabolism the formation of para-aminobenzoic acid does not occur in the body, it does not have antisulfanilamide action and can be used in patients receiving sulfanilamide preparations. Trimecain belongs to the same group of local anesthetics. Close to them in the structure of pyromecaine.
Along with local anesthetic activity, lidocaine has pronounced antiarrhythmic properties.
Lidocaine is a strong local anesthetic that causes all kinds of local anesthesia: terminal, infiltration, conductive. Compared with novocaine, it acts faster, stronger and longer. The relative toxicity of lidocaine depends on the concentration of the solution. In low concentrations (0.5%), it is not significantly different in toxicity from novocaine; with increasing concentration (1% and 2%), the toxicity increases (by 40-50%).
For infiltration anesthesia, 0.125%, 0.25% and 0.5% solutions are used; for anesthesia of peripheral nerves - 1% and 2% solutions; for epidural anesthesia - 1% - 2% solutions; for spinal anesthesia 2% solutions.
The amount of solution and the total dose of lidocaine depend on the type of anesthesia and the nature of the surgical intervention. With increasing concentration, the total dose of lidocaine is reduced.
When using a 0.125% solution, the maximum amount of solution is 1600 ml and the total dose of lidocaine hydrochloride is 2000 mg (2 g); when using a 0.25% solution, respectively, 800 ml and 2000 mg (2 g); 0.5% solution - the total amount of 80 ml, and the total dose of 400 mg; 1% and 2% of solutions - the total amount of 40 and 20 ml, respectively, and the total dose of 400 mg (0.4 g).
For lubrication of mucous membranes (with tracheal intubation, broncho-esophagoscopy, removal of polyps, maxillary sinus punctures, etc.), 1-2% solutions are used, less often - 5% solution in a volume not exceeding 20 ml.
Lidocaine solutions are compatible with adrenaline; Add an ex tempore of 1% solution of adrenaline hydrochloride 1 drop per 10 ml of lidocaine, but not more than 5 drops for the whole amount of the solution.
The use of lidocaine as an antiarrhythmic agent is mainly due to its stabilizing effect on the cell membranes of the myocardium (the action characteristic of some other local anesthetics, adrenoblockers and other drugs that have an antiarrhythmic effect).