- To help prevent pain associated with minor surgical procedures in the ear, nose and throat
- To help prevent pain and or discomfort during dental procedures (e.g., prior to an injection)
- During general anesthesia to prevent coughing
- To help prevent pain during the final stages of childbirth, before the cutting or stitching of the perineum (skin between the vagina and anus)
Dosage & Administration
Intraspinal: Spinal anaesthesia: As hyperbaric soln of 1.5% or 5% lidocaine in 7.5% glucose soln. Normal vaginal delivery: Up to 50 mg (as 5% soln) or 9-15 mg (as 1.5% soln). Caesarian operation: Up to 75 mg (as 5% soln). Other surgical procedures: 75-100 mg.
Intravenous: Pulseless ventricular fibrillation or ventricular tachycardia : 1-1.5 mg/kg repeated as necessary. Max: 3 mg/kg. For ventricular arrhythmias in more stable patients: Usual loading dose: 50-100 mg as an IV inj at 25-50 mg/min, may repeat once or twice up to a max of 200-300 mg in 1 hr, followed by 1-4 mg/min via continuous IV infusion. May need to reduce dose if the infusion is longer than 24 hr.
Intravenous: Intravenous regional anaesthesia: As 0.5% soln w/o epinephrine: 50-300 mg. Max: 4 mg/kg.
Percutaneous infiltration anaesthesia: As 0.5% or 1% soln: 5-300 mg.
Sympathetic nerve block: As 1% soln: 50 mg for cervical block or 50-100 mg for lumbar block.
Peripheral nerve block:
- As 1.5% soln: For brachial plexus block: 225-300 mg.
- As 2% soln: For dental nerve block: 20-100 mg.
- As 1% soln: For intercostal nerve block: 30 mg;
- For paracervical block: 100 mg on each side, repeated not more frequently than every 90 min;
- For paravertebral block: 30-50 mg;
- For pudendal block: 100 mg on each side.
- As 4% soln: For retrobulbar block: 120-200 mg.
- The maximum dose is 200 mg (Approximately 20 spray).
- In dentistry, the normal dose is 1-5 sprays. Two sprays per quarter of the mouth is recommended, with a maximum of 3 sprays per quarter of the mouth over 30 minutes.
- In sinus procedures 3 sprays are used.
- In procedures of the throat and windpipe, up to 20 sprays may be necessary.
- Up to 20 sprays may be necessary in childbirth (cesarian procedure).
- Lower doses are used for children aged 3-12 years. Lidocaine 10% Spray is not recommended for children under 3 years.
Topical: Anaesthesia before e.g. venepuncture (not for infants), apply a thick layer under an occlusive dressing 1-5 hours before procedure; split skin grafting, apply a thick layer under an occlusive dressing 2-5 hours before procedure; genital warts (not for children), apply up to 10 gm 5-10 minutes before removal.
Pregnancy & Lactation
Management: Maintain oxygenation, stop convulsion and support the circulation.