• Ventricular arrhythmias:
    • IV 1-1.5 mg/kg/dose *1, may repeat dose *1 after 5min
    • Max: 300mg/total bolus dose
  • Infiltration anesthesia:
    • Percutaneous/local:
      • Adults: 1-60mL of 0.5-1% solution (5-300mg total dose)
      • Children: 4-4.5mg/kg max
    • IV regional:
      • Adults: 10-60mL of 0.5% solution (50-300mg total dose)
      • Children: 3mg/kg
  • Peripheral nerve block:
    • Brachial: 15-20mL of 1.5% solution (225-300 mg total dose)
    • Dental: 1-5mL of 2% solution (20-100 mg total dose)
    • Intercostal: 3mL of 1% solution (30 mg total dose)
    • Paravertebral: 3-5mL of 1% solution (30-50 mg total dose)
    • Pudendeal (each side): 10mL of 1% solution (100 mg total dose)
    • Paracervical obstetrical analgesia (each side): 10mL of 1% solution (100 mg total dose)
  • Sympathetic nerve block:
    • Cervical (stellate ganglion): 5mL of 1% solution (50mg total dose)
    • Lumbar: 5-10mL of 1% solution (50-100mg total dose)
  • Central neural block/epidural:
    • General: 2-3mL/dermatome for anesthesia
    • Thoracic: 20-30mL of 1% solution (200-300mg total dose)
    • Lumbar analgesia: 25-30mL of 1% solution (250-300mg total dose)
    • Lumbar anesthesia: 15-20mL of 1.5% solution (225-300mg), or 10-15mL of 2% solution (200-300mg total dose)
  • Caudal block: 200-300mg/total dose (1% or 1.5% conc. MPF) intracaudally
    • Max: 4.5mg/kg/dose no more frequently than every 90min, 300mg/total dose
  • Spinal anesthesia:
    • Obstetrical: 50-75mg (5% hyperbaric) intrathecally *1
    • Surgical: 75-100mg (5% hyperbaric) intrathecally *1
  • Status epilepticus (Off-label):
    • IV 1mg/kg/dose *1 then may give 0.5mg/kg/dose *1 2min after 1st dose, then 30mcg/kg/min
  • Injection/Gel/Spray:
    • 1%
    • 2%
    • 10%

Local thrombophlebitis may occur in patients receiving prolonged IV infusions

Amide local anesthetic

It inhibits Na ion channels, stabilizing neuronal cell membranes and inhibiting nerve impulse initiation and conduction

It also works by depressing action potential phase 0 (class Ib antiarrhythmic)

  • Injection site pain
  • Lightheadedness
  • Tremor
  • Confusion
  • Hypotension
  • Blurred vision
  • Tinnitus
  • Anxiety
  • Dizziness
  • Euphoria
  • Drowsiness
  • Lethargy
  • Nausea
  • Vomiting
  • Agitation
  • Hot sensation
  • Cold sensation
  • Hallucinations
  • Hypersensitivity to drug or amide type anesthetic
  • Intra-articular continuous infusion use
  • Coagulopathy (spinal anesthesia use)
  • Severe cardiac impairment (spinal anesthesia use)
  • Sepsis (spinal anesthesia use)
  • Injection site infection (spinal anesthesia use)
  • Caudal use (methylparaben-containing form)
  • Epidural use (methylparaben-containing form)
  • Intrathecal use (except 5% hyperbaric form)
  • Adams-Stokes syndrome
  • WPW syndrome
  • Heart block (patients without pacemaker)
  • Lidocaine topical
  • Prilocaine topical
  • Saquinavir

                          Drug Status

Availability Prescription only
Pregnancy Category B; Can be used
Breastfeeding Use with caution
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Anasica 1% w/v Injection 30mL Asence Pharma Medisel Kenya
Curaine 2% w/v Injection 30mL Crown Healthcare Crown Healthcare
Gesicain 2% w/v Injection 30mL KNVM Medicare KNVM Medicare
Jasocaine 2% w/v Injection 20mL, 30mL Jayson Pharma Jayson Pharma
Lidocaine 2% w/v Injection 30mL Dawa Ltd Dawa Ltd
Lidocaine 2% w/v Injection 1’s Galaxy Pharma Galaxy Pharma
Lignocaine Fresenius 2% w/v Injection 20mL Fresenius Kabi Surgipharm Ltd
Lignox 2% 2% w/v Injection 30mL Indoco Remedies Sai Pharma
Lox 2% 2% w/v Injection 30mL Neon Labs Ripple Pharma
Metacain 2% w/v Gel 30g Galentic Pharma Avacare Kenya
Xylocaine 10% 10% w/v Spray 50mL Beta Healthcare Beta Healthcare
Xylocaine 2% 2% w/w Gel 30g Beta Healthcare Beta Healthcare