Lidocaine

Lidocaine is a medicine to relieve pain or to numb certain parts of the body (local anesthetic). This drug can also be used to treat certain types of arrhythmias, so it is also included in the class of antiarrhythmic drugs.

Lidocaine works by blocking the signals that cause pain, thereby temporarily preventing pain. Lidocaine is available in various dosage forms for different purposes.

The following is an explanation of lidocaine dosage forms and their intended use:

1. Topical drug lidocaine (cream, gel, ointment)
   Used to numb the skin area. This type of preparation is usually used before certain medical procedures or can be used to relieve pain from insect bites, exposure to poisonous plant sap , minor cuts, or minor burns .
2. Lidocaine spray
   is used to numb the mouth or throat before undergoing certain medical procedures, such as inserting a breathing tube or gastroscopy .
3. Lidocaine injection / injection
   Used to cause a numbing effect on certain areas of the body. This type of preparation can be used before the process of suturing a torn wound or caesarean section .
   Apart from being used as a local anesthetic, lidocaine injection is also used to treat arrhythmias or heart rhythm disturbances.
4. Lidocaine suppositories
   Used to relieve pain, itching, or swelling of the anus due to hemorrhoids or other disorders of the anal area. The drug is used by inserting it through the anus or rectum.
5. Lidocaine lozenges
   Used to relieve sore throats. For this dosage form, further research is still needed to determine its effectiveness and safety.
6. Lidocaine ear drops
   Used to reduce pain and swelling in inflammation of the middle ear ( otitis media ) or inflammation of the outer ear ( otitis externa ). As with lidocaine lozenges, the effectiveness and safety of using lidocaine ear drops still requires further research.

Lidocaine trademarks:  Colme, Emla, Extracaine, Lignovell, Liposin, Nelicort, Otilon, Otopain, Pehacain, Topsy, Ultraproct N, Xylocaine

What is Lidocaine

Precautions Before Using Lidocaine

Lidocaine should only be used as prescribed by a doctor. Before using this drug, you need to pay attention to the following points:

• Do not use lidocaine if you are allergic to this drug. Tell your doctor about any history of allergies you have.
• Tell your doctor if you have or have had heart disease, lung disease, methemoglobinemia , heart rhythm disturbances (arrhythmias), sepsis , liver disease, glucose-6-phosphate dehydrogenase ( G6PD ) deficiency.
• Please be careful, patients with heart rhythm disorders who receive injectable lidocaine must first perform an electrocardiography (ECG) examination . This is done to help the doctor the type and duration of treatment.
• Tell your doctor if you are taking certain medications, supplements or herbal products.
• Tell your doctor if you are pregnant, planning to become pregnant, or are breastfeeding.
• Immediately see a doctor if there is an allergic drug reaction or overdose after using lidocaine.

Dosage and Rules for Using Lidocaine

The dose of lidocaine in each person can be different based on the patient's condition and the form of the drug. The following is the dose of lidocaine for adults:

Condition: Epidural anesthesia

• Injections into the spinal cord (lumbar epidural, thoracic epidural, or caudal analgesia): 250–300 mg as a 1% solution for lumbar/lower epidural analgesia.

Condition: Spinal anesthesia

• Injections of the spinal nerves (spinal): Dose of 50 mg–100 mg as a 5% solution depending on the type of surgery.

Condition: Regional anesthesia of a specific body part

• Intravenous injection: 50–300 mg as a 0.5% solution. Maximum dose: 4 mg/kgBB.

Condition: Anesthesia in external areas (skin, oral cavity, urethra)

• Spray: Spray 40–200 mg of the 4% solution onto the area to be anesthetized.
• Ointment 5% : Dose of 5 grams for each administration, a maximum of 20 g per day for the skin or mucous lining, such as the oral cavity.
• 2% gel: Usually used before inserting a urinary catheter. For women, 60–100 mg. For men, 100–200 mg.

Condition: Hemorrhoids and anal itching

• Suppositories : Used 2–3 times a day.

Condition: Sore throat

• Lozenges: Discuss with your doctor the method and dosage required

Condition: Otitis externa

• Ear drops: Dose of 4–5 drops in the ear canal 2–4 times per day.

Condition: Arrhythmia

• Injection (emergency): A dose of 300 mg is given into the muscle of the shoulder. May repeat after 60–90 minutes, if needed.
• Inject (stable): Dose 1–1.5 mg/kg, can be repeated if needed. The maximum dose is 3 mg/kg, can be repeated 2 times. The dose needs to be reduced if the use of the drug is longer than 24 hours.

How to Use Lidocaine Properly

Follow the doctor 's recommendations and read the information printed on the lidocaine packaging before starting to use it. Do not reduce or increase your dose without consulting your doctor first.

Lidocaine spray is usually given by the doctor just before the medical procedure begins. Avoid eating and drinking until the numbing effect wears off, as this medication may cause you to have difficulty swallowing or accidentally bite into the inside of your mouth.

Administration of injectable lidocaine will be given directly by a doctor or medical officer under the supervision of a doctor. Tell your doctor about the conditions or diseases that you are currently or have had, so that the doctor can adjust the dosage and duration of treatment.

Before using topical lidocaine, wash your hands with soap first. Avoid contact between the drug and the eyes. In case of contact with eyes, rinse eyes immediately with clean running water.

For lidocaine suppositories, drug administration is done through the anus. Moisten the medicine with water so that it is easy to insert. Drug administration can be done by standing and lifting one leg, or lying down with one leg bent and the other straight. This was done so that the position of the buttocks was more open so as to facilitate the process of inserting the drug.

Gently push the suppository into the anus, pointed end first, until it is 2–3 cm deep. After the medicine is put in, keep sitting or lying down and wait about 15 minutes for the medicine to melt. Always prioritize hand and body hygiene before and after using the drug.

Consumption of lidocaine lozenges is only done when needed. Check the packaging before taking the drug. If the packaging is damaged or opened, the drug should not be consumed.

The use of lidocaine ear drops is done by lying on the side or tilting the head, so that the ear hole where the medicine will be dripped is facing upwards. After dripping, hold the position and wait for 2 minutes for the drug to enter.

Store lidocaine at room temperature and avoid direct sunlight. Keep medicine out of reach of children.

Lidocaine Interactions with Other Drugs

Lidocaine can cause drug interactions when used with other drugs. The following are some of the effects of drug interactions that can occur:

• Increased blood levels of lidocaine when used with cimetidine or propranolol
• Increased risk of heart problems when used with beta blocker drugs , for example bisoprolol
• Increased side effects on the heart when used with injectable phenytoin
• Decreased effectiveness of lidocaine when used with loop diuretics, acetazolamide , or thiazides

Side Effects and Dangers of Lidocaine

Some of the side effects that may arise after using lidocaine are:

• Nausea , vomiting, or constipation
• Dizzy
• pins and needles
• Tremors
• Headache
• Hypotension
• Skin irritation, redness, or swelling at the injection site or on the lidocaine applied skin

Check with your doctor if the side effects above don't go away or get worse. Immediately see a doctor if you experience an allergic drug reaction or more serious side effects, such as:

• seizures
• Heart rhythm disturbances or cardiac arrest
• Joint pain or muscle pain
• Methemoglobinemia characterized by cyanosis, fatigue, shortness of breath
• The skin bruises or bleeds easily
• Hyperthermia