Description of the medicine: Lidocaine hydrochloride (Lidocaini hydrochloridum)
LIDOCAINE HYDROCHLORIDE (Lidocaini hydrochloridum).
2-Diethylamino-2 ', 6'-acetoxylidide hydrochloride, or a-diethylamino-2, 6-dimethylacetanilide hydrochloride, monohydrate.
Synonyms: Xicain, Xylocaine, Lidestin, Acetoxyline, Alocaine, Anestacon, Anestecain, Astracaine, Dolicaine, Dulcicaine, Esracaine, Fastocaine, Leostesin, Lidestin, Lidocaine, Lidocard, Lidocaton, Laineecain, Lainocaine, Lainocaine Xycain, Xylesin, Xylocain, Xylocard, Xylocitin, Xyloton, Xylotox, etc.
White or almost white crystalline powder. Very soluble in water, soluble in alcohol.
By the chemical structure, xylocaine is a derivative of acetanilide. Unlike novocaine, it is not an ester, it 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 an antisulfanilamide effect and can be used in patients receiving sulfanilamide preparations. Trimecaine belongs to the same group of local anesthetics. Close to them in the structure of pyromecaines.
Along with local anesthetic activity, lidocaine has pronounced antiarrhythmic properties.
Lidocaine is a strong local anesthetic that causes all types of local anesthesia: terminal, infiltration, conduction. Compared to novocaine, it acts faster, stronger and longer. The relative toxicity of lidocaine depends on the concentration of the solution. In small concentrations (0.5%), it does not significantly differ in toxicity from novocaine; with increasing concentration (1% and 2%), 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 surgery. With increasing concentration, the total dose of lidocaine is reduced.
When using 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, 800 ml and 2000 mg (2 g), respectively; 0.5% solution - the total amount is 80 ml, and the total dose is 400 mg; 1% and 2% solutions - a total of 40 and 20 ml, respectively, and a total dose of 400 mg (0.4 g).
To lubricate the mucous membranes (with tracheal intubation, bronchoesophagoscopy, removal of polyps, maxillary sinus punctures, etc.), 1 - 2% solutions are used, less often - 5% solution in a volume of not more than 20 ml.
Lidocaine solutions are compatible with epinephrine; add ex tempore 1% solution of adrenaline hydrochloride 1 drop per 10 ml of xicaine solution, but not more than 5 drops per total amount of solution.
The use of lidocaine as an antiarrhythmic agent is mainly due to its stabilizing effect on the myocardial cell membranes (an action characteristic of some other local anesthetics, adrenergic blockers, and other drugs that have an antiarrhythmic effect).