Lignocaine 2%

Question 1

Pharmacology and presentation of Lignocaine?

Answer 1

100mg/5ml

Local anaesthetic, that blocks the initiation and transmission of nerve impulses by blocking the movement of sodium ions across the nerve cell membrane in the Nervous and Cardiac conduction systems

Question 2

Indicators of Lignocaine?

• ACID

Answer 2

• Local anaesthetic for invasive procedures or nerve block
• Diluent for Ceftriaxone administration
• Conscious VT (where Amiodarone is C/I or unavailable)
• Intraosseous or thoracentesis needle placement for injection site pain.

Question 3

Contraindications of Lignocaine?

• Allergy and heart (4chambers)

Answer 3

• Known allergy
• Conscious VT associated with:
  › Bradycardia
  › Current heart failure
  › Torsade de Pointes
  › Conduction defects or heart blocks.

Question 4

Cautions of Lignocaine?

Answer 4

• Hypotension and poor perfusion in the conscious VT
• Arrhythmias if given inadvertently IV during IM/SC administration.

Question 5

Side Effects of Lignocaine?
- Brain, Ear, Mouth and Heart

Answer 5

• Convulsions
• Hypotension
• Nausea
• Tinnitus.

Question 6

Dosing Regimes of Lignocaine?

Answer 6

Diluent for Ceftriaxone
- 7mg IM

Pain for IO insertion
- Adult = 60mg IO, broken up into 40mg initial dose, 10mg saline flush then 20mg remaining dose, once
- Paed = 1mg/kg IO, single dose to a max of 20mg

Question 7

Onset and duration of Lignocaine?

Answer 7

• Onset = 1–10 minutes
• Duration = 1 hour