Details
Presentation:
50 mg in 5 mL amp (1% solution)
Route:
IM (when used to reconstitute Ceftriaxone only)
Local tissue infiltration (for chest decompression)
IO – infuse slowly over 120 seconds and allow to dwell for 60 seconds. Flush IO catheter with normal saline (5 – 10mL for adults, 2 – 5 mL for paediatrics)
Onset of action:
1 – 5 minutes (infiltration); 5 – 15 minutes (other routes)
Duration:
1 – 1.5 hours
Mode of action
Sodium channel blocker – interrupts impulse conduction in peripheral nerves and stabilises excitable cell membranes
- Local anaesthetic to reduce pain associated with:
- Intramuscular administration of Ceftriaxone
- Chest decompression in patients with GCS > 10 (MICA only)
- Intraosseous administration of medication or fluid in a conscious patient (MICA only)
- Known hypersensitivity to lidocaine or related local anaesthetics (bupivacaine, levobupivacaine, prilocaine, ropivacaine)
- IM and local infiltration – inadvertent intravascular administration may result in systemic toxicity (see below)
- IO – impaired CV function (e.g. hypotension, bradycardia, poor perfusion, heart block, heart failure)
- Allergic reactions are rare and may present as localised oedema, urticaria, bronchospasm and anaphylaxis
- Signs of systemic toxicity include:
- CNS: tinnitus, blurred vision, sudden change in conscious state, agitation, convulsions
- CV: hypotension, bradycardia, arrhythmias (e.g. conduction blocks, ventricular tachyarrhythmias), cardiac arrest
Significant interactions
- Nil
Pregnancy
- Safe to use
- Safe to use
Notes
- Lidocaine and lignocaine are the same medication, but lidocaine is the preferred name internationally. Both names will be in use in Australia until 2023.
Infusion
- None