lidocaine hydrochloride + dextrose

Lidocaine hydrochloride + dextrose is a combination medication available in different formulations for specific medical uses. It consists of lidocaine hydrochloride (an amide-type local anesthetic and antiarrhythmic agent) combined with dextrose in a sterile solution. The medication comes in two main formulations: 1. For intravenous use (0.4% or 0.8% lidocaine with 5% dextrose) - used as a cardiac antiarrhythmic agent[1][9] 2. For spinal anesthesia (5% lidocaine with 7.5% dextrose) - used as a hyperbaric solution for spinal anesthesia[2][5] ## Intravenous Formulation The intravenous formulation is specifically indicated for: - Acute management of ventricular arrhythmias during cardiac manipulations (such as cardiac surgery) - Life-threatening arrhythmias of ventricular origin (such as during acute myocardial infarction)[1][3] The onset of action after intravenous injection is rapid (45-90 seconds), with a duration of action of 10-20 minutes[4]. For continuous infusion, the medication is typically administered at a rate of 1-4 mg/min for adults (20-50 mcg/kg/min)[1][9]. ## Spinal Anesthesia Formulation The spinal anesthesia formulation (5% lidocaine with 7.5% dextrose) is a hyperbaric solution used for spinal anesthesia[2][5]. The duration of perineal anesthesia provided by 1 mL (50 mg) averages 100 minutes, with analgesia continuing for an additional 40 minutes. For surgical anesthesia, 1.5 to 2 mL (75 to 100 mg) provides approximately two hours of anesthesia[5]. ## Mechanism of Action Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anesthetic action[2][5]. For cardiac arrhythmias, lidocaine's mode of action appears similar to procaine, procainamide, and quinidine. It depresses ventricular excitability and increases the stimulation threshold of the ventricle during diastole, while the sinoatrial node remains unaffected[4]. ## Contraindications The medication is contraindicated in: - Patients with known hypersensitivity to local anesthetics of the amide type - Patients with Stokes-Adams syndrome, Wolff-Parkinson-White syndrome - Patients with severe degrees of sinoatrial, atrioventricular, or intraventricular block - Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products[1][3] ## Administration and Dosage For intravenous use, constant monitoring with an electrocardiograph is essential. The medication should only be administered with a calibrated infusion device[3][9]. For spinal anesthesia, the solution may be administered in the right or left lateral recumbent or sitting position, and the patient can be positioned according to surgical requirements after the anesthetic has become fixed (usually 5-10 minutes)[5]. ## Pharmacokinetics Lidocaine is completely absorbed following parenteral administration. The elimination half-life following an intravenous bolus injection is typically 1.5 to 2.0 hours. This half-life may be prolonged two-fold or more in patients with liver dysfunction. In patients with severe renal dysfunction, lidocaine clearance is decreased by half[6]. Pharmacokinetic data indicate reduced elimination of lidocaine after prolonged infusion (24 hours) with resultant prolongation of the half-life to approximately three times that seen following a single administration[1][9].

Brand names

Lidocaine Hydrochloride and Dextrose Injection

Other names

lidocaine and dextroselidocaine hydrochloride and dextrose injectionlidocaine hydrochloride and 5% dextrose injection