Lidocaine Hydrochloride and Epinephrine Injection contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. Sterilization, Storage and Technical Procedures: The sedated patient may exhibit only a pulse rate increase of 20 or more beats per minute for 15 or more seconds.
The test dose should be repeated if the patient is moved in a manner that may have displaced the catheter. The first consideration is prevention, best accomplished by careful monitoring of cardiovascular and respiratory vital signs and the patient's state of consciousness after each local anesthetic injection. Lumbar and caudal epidural anesthesia should be used with extreme caution in persons with the following conditions: Objective adverse manifestations become increasingly apparent with increasing venous plasma levels above 6.
Do not use the injection if its color is pinkish or darker than slightly yellow or if it contains a precipitate. Studies of lidocaine in animals to evaluate the carcinogenic and mutagenic potential or the effect on fertility have not been conducted.
Lidocaine should also be used with caution in patients with severe shock or heart block. In situations when concurrent therapy is necessary, careful patient monitoring is essential. Paracervical block is no longer recommended during labour because it results in very high levels of the drug in fetal blood.
Dosing & Uses
Successful outcome is dependent on early diagnosis, prompt discontinuance of the suspect triggering agent s and institution of treatment, including oxygen therapy, indicated supportive measures and dantrolene consult dantrolene sodium intravenous package insert before using.
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There have been adverse event reports of chondrolysis in patients receiving intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures.
Note, however, that the absence of blood in the syringe does not guarantee that intravascular injection has been avoided. Share cases and questions with Physicians on Medscape consult. For Infiltration and Nerve Block. Sign Up It's Free! Chondrolysis associated with intra-articular infusions following arthroscopic and other surgical procedures off-label use. This restriction typically requires that certain criteria be met prior to approval for the prescription.
The long term significance of these observations is unknown. The time of onset of symptoms, such as joint pain, stiffness and loss of motion can be variable, but may begin as early as the 2nd month after surgery. The use of some local anesthetic drug products during labor and delivery may be followed by diminished muscle strength and tone for the first day or two of life.
The aim is to administer the smallest effective dose. This restriction typically limits the quantity of the drug that will be covered. At the first sign of change, oxygen should be administered. It has the following structural formula:.