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LOCAL ANAESTHETIC AGENTS

Posted by SAMUEL ISABIRYE on February 18, 2013 at 8:35 AM

Lignocaine:

 

Solution concentrations of lignocaine commonly

used:

 

Topical-larynx pharynx 20-40mg/ml or

100mg/ml

Infiltration 2.5- 5mg/ml ± with adrenaline

1:2.000.000

Nerve block 10- 20mg/ml ± adrenaline

1:2.000.000

Spinal 50mg/ml hyperbaric solution

Action:

fast onset

Plain lignocaine 40 – 60 min

Lignocaine with adrenaline 60 – 90 min

 

Dose: lignocaine with adrenaline 6-7mg/kg body

weight

Plain lignocaine 3mg/kg body weight

 

It is important to calculate the volume of lignocaine

that could be used safely

Note: lignocaine toxicity-

 

Signs and symptoms

CNS stimulation followed by depression

o

Stimulation –restlessness, tremor,

convulsions

o

Depression – semi consciousness, coma

Treatment

Give sufficient/ titrate IV diazepam to

control convulsions

Thiopentone may be used e.g. 50mg

Oxygen is given

Support airway, breathing and circulation

as indicated

Admit the patient to ward to continue

treatment and observation as needed.

 

Bupivacaine:

 

Solution concentration 5mg/ml

Action: slow onset but long duration 4-6 hours or

longer

 

UCG 2010

426

 

 

 

18. Miscellaneous conditions

Dose: 2mg/kg body weight

 

Indication:

all regional anaesthesia except

intravenous regional anaesthesia. Use

hyperbaric bupivacaine solution for

spinal anaesthesia.

 

Other drugs:

 

Analgesics, Naloxone, Noestigmine, Atropine,

Diazepam

 

Drugs for managing the following condition:

 

Anaphylaxis, Cardiac arrhythmias, Pulmonary

oedema, Hypotension, Hypertension,

Bronchospasm, Respiratory depression,

Hypoglycaemia, Hyperglycaemia, Adrenal

dysfunction, Raised intracranial pressure, uterine

atony, Coagulopathies: (Refer to the relevant

sections)

 

Categories: None

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