Xylocaine - Lidocaine

Cocaine is still a drug of choice among many physicians as a topical local anesthetic because the drug has vasoconstrictive qualities (shrinks and stops the flow of blood). Synthetic local anesthetics such as novacaine and xylocaine (lidocaine) have also been discovered and used extensively as a local anesthetic. 

In many cases, no sedation is required except that provided by sterile Xylocaine (lidocaine) jelly that lubricates the catheter in boys. A quick examination performed by an experienced radiologist should not be painful. Postprocedural minor discomfort can occur, and it seems less worrisome when announced. Improvement by hydration and local care is the rule. In some children, major anxiety can be present. Inhalation of an equimolecular mixture of nitrous oxide and oxygen (Entonox) in fasting children can be helpful (Schmit and Sfez 1997). In uncooperative children who are too young to breathe gas, rectal midazolam can occasionally be used (Hypnovel 0.3 mg/kg, maximal dose 5 mg). For safety, sedation procedures should preferably be organized in collaboration with the department of anesthesiology. 

Lidocaine hydrochloride [73-78-9] (Xylocaine), is the most versatile local anesthetic agent because of its moderate potency and duration of action, rapid onset, topical activity, and low toxicity. Its main indications are for infiltration, peripheral nerve blocks, extradural anesthesia, and in spinal anesthesia where a duration of 30 to 60 min is desirable. Because of its vasodilator activity, addition of the vasoconstrictor, epinephrine, increases the duration of action of Hdocaine markedly. It is also available in ointment or aerosol preparations for a variety of topical appHcations. 

Lidocaine (Xylocaine), die representative class I-B drug, raises the threshold of the ventricular myocardium. Threshold is a term applied to any stimulus of the lowest intensity that will give rise to a response in a nerve fiber. A stimulus must be of a specific intensity (strength, amplitude) to pass along a given nerve fiber (Fig. 40-2). 

After receiving lidocaine hydrochloride (Xylocaine HCI), the threshold is raised to a higher level, allowing fewer stimuli to reach the threshold. This results in decreased stimulation of the nerve fiber and prevents conduction of the nerve impulses causing the arrthvthmia. 

Which of the following adverse reactions of lidocaine (Xylocaine) should be reported immediately to the primary care provider ... 

Lidocaine is the most widely used local anesthetic. Its excellent therapeutic activity is fast-acting and lasts sufficiently long to make it suitable for practically any clinical use. It stabilizes cell membranes, blocks sodium channels, facilitates the secretion of potassium ions out of the cell, and speeds up the repolarization process in the cell membrane. It is used for terminal infiltration, block, epidural, and spinal anesthesia during operational interventions in dentistry, otolaryngology, obstetrics, and gynecology. It is also used for premature ventricular extrasystole and tachycardia, especially in the acute phase of cardiac infarction. Synonyms for this drug are xylocaine, neflurane, and many others. 

Like procainamide, lidocaine is an amide with local anesthetizing action. Lidocaine is usually administered intravenously for short-term therapy of ventricular extrasystole, tachycardia, especially in the severe phase of myocardial infarction, arrhythmia of natural cause, and for arrhythmia that can originate in the heart during surgical manipulations. Synonyms of this drug are lidopen, xylocaine, xylocard, and others. 

Lidocaine (Xylocaine) was introduced as a local anesthetic and is still used extensively for that purpose (see Chapter 27). Lidocaine is an effective sodium channel blocker, binding to channels in the inactivated state. Lidocaine, like other IB agents, acts preferentially in diseased (ischemic) tissue, causing conduction block and interrupting reentrant tachycardias. 

Lidocaine hydrochloride Xylocaine) is the most commonly used local anesthetic. It is well tolerated, and in addition to its use in infiltration and regional nerve blocks, it is commonly used for spinal and topical anesthesia and as an antiarrhythmic agent (see Chapter 16). Lidocaine has a more rapidly occurring, more intense, and more prolonged duration of action than does procaine. 

Rx with neomycin, (NeoDecadron, Ak-Neo-Dex) with neomycin and polymixin B (Dexacidin, Maxitrol, Dexasporin) with tobramycin (Tobradex) with lidocaine (Decadron with Xylocaine)... 

Anesthetic Lidocaine Xylocaine Microcrystalline wax, mineral oil, propylene glycol, white petrolatum... 

Secobarbital (Seconal) Diphenhydramine (Benadryl) Glutethimide (Doriden) Meprobamate (Miltown) Lidocaine (Xylocaine) Prominal (Mebaral)... 

Lidocaine Xylocaine Rapid Intermediate Infiltration Peripheral Nerve Block Epidural Spinal Transdermal Topical Sympathetic block Intravenous regional block... 

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