Lignocaine/ Adrenaline

Registered South African indications:

• Local anaesthetic
• Dental extractions or operations

Contraindications

• Hypersensitivity to local anaesthetics of the amide type (e.g. lidocaine hydrochloride)
• Patients with thyrotoxicosis
• Cardiac disease, particularly those with arrhythmia or hypertension
• Narrow-angle glaucoma
• Patients with myasthenia gravis
• Coadministration with tricyclic antidepressants

Cautions

• Breastfeeding
• Hepatic impairment
• Intravenous administration
• Epilepsy
• Myasthenia gravis

Forms avail. in SA and in this monograph: inj

Local anaesthetic
Dental extractions

• Local infiltration: Dosage dependant on nature, magnitude and duration of procedure involved; Max: 7mg/kg

See adult dosage

Pregnancy

• FDA Pregnancy Category B

Breastfeeding

• Caution

Renal Impairment

• No dose adjustment recommended 

Hepatic Impairment

• Caution; dose adjustment recommended  

Elderly

• No dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Seizures 

Cardiovascular Disorders

• Hypotension
• Arrhythmias
• Cardiovascular collapse

Respiratory Disorders 

• Respiratory collapse

Gastrointestinal Disorders

• Nausea and vomiting

Musculoskeletal Disorders

• Muscle twitching

• Tricyclic antidepressants
• Monoamine oxidase inhibitors
• Alpha blockers
• Beta blockers

None routine

Lignocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses thereby effecting local anesthetic action. Lignocaine alters signal conduction in neurons by blocking the fast voltage gated sodium (Na+) channels in the neuronal cell membrane that are responsible for signal propagation. With sufficient blockage the membrane of the postsynaptic neuron will not depolarize and will thus fail to transmit an action potential. This creates the anaesthetic effect by not merely preventing pain signals from propagating to the brain but by aborting their birth in the first place.

COMBINATION PREPARATIONS

Lignocaine/ Adrenaline

Injection (per ml) 20mg/12.5μg

• Xylotox E80-A  (Adcock Ingram) originator