Allergic reactions may occur as a result of sensitivity to local anesthetic agents. Select one or more newsletters to continue. At the first sign of change, oxygen should be administered. - Ügyelni kell, hogy a légutakba ne kerüljön. Initially 50–100 mg, followed by (by intravenous infusion) 120 mg, dose to be given over 30 minutes, then (by intravenous infusion) 240 mg, dose to be given over 2 hours, then (by intravenous infusion) 60 mg/hour, reduce dose further if infusion is continued beyond 24 hours, if infusion not immediately available following initial injection, the initial injection dose may be repeated at intervals of not less … Lidocaine bekerja dengan cara menghambat sinyal penyebab nyeri sehingga mencegah timbulnya rasa sakit untuk sementara. Subsequent adverse effects may depend partially on the amount of drug administered subdurally. Data sources include IBM Watson Micromedex (updated 2 Feb 2021), Cerner Multum™ (updated 3 Feb 2021), ASHP (updated 29 Jan 2021) and others. Der Nachweis von Lidocain in einer Urinprobe nach dem Rennen steht somit unter Strafe. It is also used to treat ventricular tachycardia. Dosierung - speziell The majority of reported cases of chondrolysis have involved the shoulder joint; cases of gleno-humeral chondrolysis have been described in pediatric and adult patients following intra-articular infusions of local anesthetics for periods of 48 to 72 hours. Dialysis is of negligible value in the treatment of acute overdosage with Lidocaine HCl. Endotracheal intubation, employing drugs and techniques familiar to the clinician, may be indicated, after initial administration of oxygen by mask, if difficulty is encountered in the maintenance of a patent airway or if prolonged ventilatory support (assisted or controlled) is indicated. Each mL contains Lidocaine hydrochloride, anyhydrous 10 mg; sodium chloride 7 mg. These reactions may be due to intra-arterial injection of the local anesthetic with retrograde flow to the cerebral circulation. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Anesthesiology 47: 437, 1977]. Lidocain wird von der Association of Racing Commisioners International (ARCI) als "class 2 foreign substance" eingestuft. There have been no reports of cross-sensitivity between Lidocaine hydrochloride and procainamide or between Lidocaine hydrochloride and quinidine. In all cases the lowest concentration and smallest dose that will produce the desired result should be given. A study of the concentration in the spinal fluid. Lidocaine HCl Injection, USP is a sterile, nonpyrogenic, isotonic solution containing sodium chloride. Lidocaine (Lidbree) 42 mg/mL intrauterine gel was approved in the UK for topical anaesthesia for moderate acute pain during cervical and intrauterine procedures, in adults and adolescents from 15 years of age [1]. Lidocaine infusions were discontinued upon complete pain relief, experiencing of intolerable side effects, after 30 minutes of infusion, or if requested by patients. Hematologic Methemoglobinemia. Allow a 5-minute interval between sides. Excessive blood levels may cause changes in cardiac output, total peripheral resistance, and mean arterial pressure. Note, however, that the absence of blood in the syringe does not guarantee that intravascular injection has been avoided. General consideration should be given to this fact before administering Lidocaine HCl to women of childbearing potential, especially during early pregnancy when maximum organogenesis takes place. To avoid intravascular injection, aspiration should be performed before the local anesthetic solution is injected. The net effect is normally a modest hypotension when the recommended dosages are not exceeded. Lidocaine HCl crosses the blood-brain and placental barriers, presumably by passive diffusion. Since amide-type local anesthetics are metabolized by the liver, Lidocaine HCl Injection, USP should be used with caution in patients with hepatic disease. Proper tourniquet technique, as described in publications and standard textbooks, is essential in the performance of intravenous regional anesthesia. Lidocaine HCl Injection, USP is not approved for this use (see WARNINGS and DOSAGE AND ADMINISTRATION). Scandinav. As a precaution against the adverse experience sometimes observed following unintentional penetration of the subarachnoid space, a test dose such as 2 to 3 mL of 1.5% Lidocaine HCl should be administered at least 5 minutes prior to injecting the total volume required for a lumbar or caudal epidural block. The use of obstetrical anesthesia may increase the need for forceps assistance. Patients with peripheral vascular disease and those with hypertensive vascular disease may exhibit exaggerated vasoconstrictor response. Om medicin.dk – borger Medicin.dk – borger er en del af Medicin.dk. The physician should weigh the possible advantages against risks when considering a paracervical block in prematurity, toxemia of pregnancy, and fetal distress. Do not use if solution is discolored or contains a precipitate. For the most updated list of ABA Keywords and definitions go to, OA/SPA Pediatric Anesthesia Virtual Grand Rounds. The first step in the management of convulsions, as well as underventilation or apnea due to unintended subarachnoid injection of drug solution, consists of immediate attention to the maintenance of a patent airway and assisted or controlled ventilation with oxygen and a delivery system capable of permitting immediate positive airway pressure by mask. The following types are those most commonly reported: CNS manifestations are excitatory and/or depressant and may be characterized by lightheadedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, nausea and vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest. Local anesthetics rapidly cross the placenta and when used for epidural, paracervical, pudendal or caudal block anesthesia, can cause varying degrees of maternal, fetal and neonatal toxicity (see CLINICAL PHARMACOLOGY, Pharmacokinetics and Metabolism). Solupharm Pharmazeutische Erzeugnisse GmbH, FOR INFILTRATION AND NERVE BLOCK INCLUDING EPIDURAL AND CAUDAL USE. Tolerance to elevated blood levels varies with the status of the patient. Lidocaine is a local anaesthetic of the amide type. Lidocaine is used to provide anaesthesia by nerve blockade at various sites in the body and in the control of dysrhythmias. Teratogenic Effects: Pregnancy Category B. Reproduction studies have been performed in rats at doses up to 6.6 times the human dose and have revealed no evidence of harm to the fetus caused by Lidocaine HCl. The test dose should be repeated if the patient is moved in a manner that may have displaced the catheter. Nach rund 15 min ist die maximale Anästhesieausbreitung erreicht. Säilytä tämä pakkausseloste. Drowsiness following the administration of Lidocaine HCl is usually an early sign of a high blood level of the drug and may occur as a consequence of rapid absorption. Disinfecting agents containing heavy metals, which cause release of respective ions (mercury, zinc, copper, etc) should not be used for skin or mucous membrane disinfection as they have been related to incidents of swelling and edema. Lumbar and caudal epidural anesthesia should be used with extreme caution in persons with the following conditions: existing neurological disease, spinal deformities, septicemia, and severe hypertension. However, spinal administration of lidocaine has been associated with nerve root irritation (transient radicular irritation), the mechanism of which is not well understood, resulting in the reluctance of many anesthesiologists to continue using lidocaine for spinal anesthesia. Es besticht mit seiner schnellen Anschlagszeit (<5 min) und der verlässlichen motorischen Blockade. Spinal Anesthesia Using Lidocaine and Sufentanil and (Transient Neurological Symptoms) TNS. Since it is not known whether amide-type local anesthetics may trigger this reaction and since the need for supplemental general anesthesia cannot be predicted in advance, it is suggested that a standard protocol for the management of malignant hyperthermia should be available. Cases compatible with unintended fetal intracranial injection of local anesthetic solution have been reported following intended paracervical or pudendal block or both. Reuse of OpenAnesthesia™ content for commercial purposes of any kind is prohibited. Inject slowly, five minutes between sides (see also discussion of paracervical block in PRECAUTIONS). Can be resterilized by autoclaving. The initial lidocaine … An intravascular injection is still possible even if aspirations for blood are negative. The Use of Lidocaine for Spinal Anesthesia. When clinical conditions permit, consideration should be given to employing local anesthetic solutions that contain epinephrine for the test dose because circulatory changes compatible with epinephrine may also serve as a warning sign of unintended intravascular injection. Epidural, spinal, paracervical, or pudendal anesthesia may alter the forces of parturition through changes in uterine contractility or maternal expulsive efforts. Backache and headache have also been noted following use of these anesthetic procedures. Br J Anaesth 89: 849, 2002]. Fetal heart rate should always be monitored during paracervical anesthesia. The primary metabolite in urine is a conjugate of 4-hydroxy-2,6-dimethylaniline. Lidocaine HCl Injection, USP is indicated for production of local or regional anesthesia by infiltration techniques such as percutaneous injection and intravenous regional anesthesia by peripheral nerve block techniques such as brachial plexus and intercostal and by central neural techniques such as lumbar and caudal epidural blocks, when the accepted procedures for these techniques as described … The rapid injection of a large volume of Lidocaine HCl Injection, USP through the catheter should be avoided, and, when feasible, fractional doses should be administered. If cardiac arrest should occur, standard cardiopulmonary resuscitative measures should be instituted. The onset of anesthesia, the duration of anesthesia and the degree of muscular relaxation are proportional to the volume and concentration (ie, total dose) of local anesthetic used. The maximum individual dose should not exceed 4.5 mg/kg (2 mg/lb) of body weight, and in general it is recommended that the maximum total dose does not exceed 300 mg. For continuous epidural or caudal anesthesia, the maximum recommended dosage should not be administered at intervals of less than 90 minutes. Lidocain 10 mg/ml injektioneste, liuos . It should be kept in mind at such times that restlessness, anxiety, tinnitus, dizziness, blurred vision, tremors, depression or drowsiness may be early warning signs of central nervous system toxicity. In a recent randomized, controlled study of 40 patients under remifentanil/propofol anesthesia, Lidocaine was found to decrease propofol requirements (P < 0.05) only during surgery. Figyelmeztetések és óvintézkedések A Lidocain spray alkalmazása előtt beszéljen kezelőorvosával vagy gyógyszerészével. In epidural anesthesia, the dosage varies with the number of dermatomes to be anesthetized (generally 2 to 3 mL of the indicated concentration per dermatome). Vielleicht möchten Sie diese später nochmals lesen. Patients on beta blockers may not manifest changes in heart rate, but blood pressure monitoring can detect an evanescent rise in systolic blood pressure. OpenAnesthesia™ content is intended for educational purposes only and not intended as medical advice. Adverse experiences following the administration of Lidocaine HCl are similar in nature to those observed with other amide local anesthetic agents. Approximately 90% of Lidocaine HCl administered is excreted in the form of various metabolites, and less than 10% is excreted unchanged. Tudnivalók a Lidocain-EGIS spray alkalmazása előtt Ne alkalmazza a Lidocain-EGIS spray-t Ha allergiás a lidokainra vagy a gyógyszer (6. pontban felsorolt) egyéb összetevőjére. Local anesthetics are actually CNS depressants, thus tonic-clonic seizures are thought to be caused by depression of inhibitory pathways. Lidocaine topical jelly or ointment is used on different parts of the body to cause numbness or loss of feeling for patients having certain medical procedures. We comply with the HONcode standard for trustworthy health information -. Patients allergic to para-aminobenzoic acid derivatives (procaine, tetracaine, benzocaine, etc.) Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Lesen Sie die gesamte Packungsbeilage sorgfältig durch, bevor Sie mit der Anwendung dieses Arzneimittels beginnen, denn sie enthält wichtige Informationen. Se liste over medicin, der indeholder Lidocain. In the rhesus monkey arterial blood levels of 18 to 21 mcg/mL have been shown to be threshold for convulsive activity. Anesth Analg 100: 97, 2005] FREE Full-text at Anesthesia & Analgesia. This amide has a … May 2008; Anesthesia & Analgesia 106(5):1587 Allergic reactions are characterized by cutaneous lesions, urticaria, edema or anaphylactoid reactions. Prompt use of supportive measures combined with forced urinary excretion of the local anesthetic has been used successfully to manage this complication. It has a rapid onset of action (about one minute following intravenous injection and fifteen minutes following intramuscular injection) and rapidly spreads through the surrounding tissues. Confusion, convulsions, respiratory depression and/or respiratory arrest, and cardiovascular stimulation or depression have been reported. Senturk’s study of 40 patients divided between IV lidocaine and controls showed that maintenance of BIS scores from 40-50 required 29% less propofol, and that the amount of propofol required to keep BIS < 45 at induction was 23% less (p < 0.001 in both instances) [Senturk M et al. Local anesthetics produce vasodilation by blocking sympathetic nerves. Volume 19, Issue 1, February 2007, Pages 25-29, February 2007, Pages 25-29 Lue tämä pakkausseloste huolellisesti, ennen kuin aloitat tämän lääkkeen käyttämisen, sillä se sisältää sinulle tärkeitä tietoja. In one study, paracervical block anesthesia was associated with a decrease in the mean duration of first stage labor and facilitation of cervical dilation. Many commercially available brands of rubbing alcohol, as well as solutions of ethyl alcohol not of USP grade, contain denaturants which are injurious to rubber and therefore are not to be used. Failure to achieve adequate analgesia with recommended doses should arouse suspicion of intravascular or fetal intracranial injection. Cardiovascular manifestations are usually depressant and are characterized by bradycardia, hypotension, and cardiovascular collapse, which may lead to cardiac arrest. Lidocaine HCl Injection, USP should also be used with caution in patients with impaired cardiovascular function since they may be less able to compensate for functional changes associated with the prolongation of A-V conduction produced by these drugs. This solution contains no bacteriostatic agent. Resuscitative equipment and personnel for treating adverse reactions should be immediately available. The intramuscular injection of Lidocaine HCl may result in an increase in creatine phosphokinase levels. To read the full-text of this research, you can request a copy directly from the author. Protect from light. Dosages in children should be reduced, commensurate with age, body weight and physical condition (see DOSAGE AND ADMINISTRATION). These adverse experiences are, in general, dose-related and may result from high plasma levels caused by excessive dosage, rapid absorption or inadvertent intravascular injection, or may result from a hypersensitivity, idiosyncrasy or diminished tolerance on the part of the patient. The time of onset of symptoms, such as joint pain, stiffness and loss of motion can be variable, but may begin as early as the 2nd month after surgery. Elevating the patient’s legs and positioning her on her left side will help prevent decreases in blood pressure. Yleisiä ohjeita. DELAY IN PROPER MANAGEMENT OF DOSE-RELATED TOXICITY, UNDERVENTILATION FROM ANY CAUSE AND/OR ALTERED SENSITIVITY MAY LEAD TO THE DEVELOPMENT OF ACIDOSIS, CARDIAC ARREST AND, POSSIBLY, DEATH. During the administration of epidural anesthesia, it is recommended that a test dose be administered initially and that the patient be monitored for central nervous system toxicity and cardiovascular toxicity, as well as for signs of unintended intrathecal administration, before proceeding. Medicin.dk leverer information om medicin, sygdom og behandling til hele Danmark. The actual volumes and concentrations to be used depend on a number of factors such as type and extent of surgical procedure, depth of anesthesia and degree of muscular relaxation required, duration of anesthesia required, and the physical condition of the patient. Acute emergencies from local anesthetics are generally related to high plasma levels encountered during therapeutic use of local anesthetics or to unintended subarachnoid injection of local anesthetic solution (see ADVERSE REACTIONS, WARNINGS, and PRECAUTIONS). Vet Anaesth Analg, March 18, 2008 {E pub}], Studies of IV lidocaine as a MAC sparing agent in humans are sparse. THE ABOVE SUGGESTED INFORMATION SERVE ONLY AS A GUIDE. “The current recommendations regarding maximum doses of local anesthetics presented in textbooks, or by the responsible pharmaceutical companies, are not evidence based (ie, determined by randomized and controlled studies). Standard textbooks should be consulted for specific techniques and precautions for various regional anesthetic procedures. Anesth Analg 55: 818, 1976], and in cats by as much as 59% [Pypendop BH et al. Rather, decisions on recommending certain maximum local anesthetic doses have been made in part by extrapolations from animal experiments, clinical experiences from the use of various doses and measurement of blood concentrations, case reports of local anesthetic toxicity, and pharmacokinetic results” {Rosenberg PH. Article. Anaphylactic reactions may occur following administration of Lidocaine hydrochloride (see ADVERSE REACTIONS). This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Generic Name: Lidocaine hydrochloride It is supplied in a 5 mL single dose ampoule, packaged within a carton of five as follows. Successful outcome is dependent on early diagnosis, prompt discontinuance of the suspect triggering agent(s) and institution of treatment, including oxygen therapy, indicated supportive measures and dantrolene (consult dantrolene sodium intravenous package insert before using). Immediately after the institution of these ventilatory measures, the adequacy of the circulation should be evaluated, keeping in mind that drugs used to treat convulsions sometimes depress the circulation when administered intravenously. Prepared in Germany. Medically reviewed by Drugs.com. It is similar to bupivacaine (Marcaine), articaine (Zorcaine), and Mepivacaine (Carbocaine). 100 mg, to be given as a bolus dose over a few minutes, followed immediately by (by intravenous infusion) 4 mg/minute for 30 minutes, then (by intravenous infusion) 2 mg/minute for 2 hours, then (by intravenous infusion) 1 mg/minute, reduce concentration further if infusion continued beyond 24 hours (ECG monitoring and specialist advice for infusion), following intravenous injection lidocaine has a … The duration of perineal anesthesia provided by 1 mL (50 mg) 5% Lidocaine Hydrochloride and 7.5% Dextrose Injection, USP averages 100 minutes, with analgesia continuing for an additional 40 minutes. Case reports of maternal convulsions and cardiovascular collapse following use of some local anesthetics for paracervical block in early pregnancy (as anesthesia for elective abortion) suggest that systemic absorption under these circumstances may be rapid. Because of the rapid rate at which Lidocaine HCl is metabolized, any condition that affects liver function may alter Lidocaine HCl kinetics. NOTE: Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever the solution and container permit. Reg Anesth Pain Med 29: 564, 2004, PMID 15635516}, Filed Under: Encyclopedia, L, Pharmacology. Wirkstoff: Lidocainhydrochlorid 1 H 2O . Lidocaine is a synthetic aminoethylamide with local anesthetic and antiarrhythmic properties. A review of lidocaine 5% medicated plasters for Post-herpetic Neuralgia Brief: Lidocaine plasters are included in the NHS England document published in July 2017: Items which should not routinely be prescribed in primary care: a consultation on guidance for CCGs. Can J Anaesth 55: 754, 2008], however the results of this study was complicated by different fentanyl dosages on induction (3 ucg/kg in the control group versus 1.5 ucg/kg in the lidocaine group). Although the incidence of side effects with Lidocaine HCl is quite low, caution should be exercised when employing large volumes and concentrations, since the incidence of side effects is directly proportional to the total dose of local anesthetic agent injected. Thus, an increase in volume and concentration of Lidocaine HCl Injection, USP will decrease the onset of anesthesia, prolong the duration of anesthesia, provide a greater degree of muscular relaxation and increase the segmental spread of anesthesia. Factors such as acidosis and the use of CNS stimulants and depressants affect the CNS levels of Lidocaine HCl required to produce overt systemic effects. Lidocaine is metabolised in the liver and about 90% of a given dose undergoes N-dealkylation to form monoethylglycinexylidide and glycinexylidide, both of which may contribute to the therapeutic and toxic effects of Lidocaine. Patients receiving these blocks should have their circulation and respiration monitored and be constantly observed. Hierdurch können einige für die beidseitige Spinalanästhesie typische Komplikationen umgangen werden. 1% Lidocaine HCl Injection, USP solution should be stored at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature]. The fetal heart rate also should be monitored continuously, and electronic fetal monitoring is highly advisable. In the case of severe reaction, discontinue the use of the drug. The potential for toxicity depends upon the procedure performed, the type and amount of drug used, and the technique of drug administration. When continuous lumbar or caudal epidural anesthesia is used for non-obstetrical procedures, more drug may be administered if required to produce adequate anesthesia. Careful adherence to recommended dosage is of the utmost importance in obstetrical paracervical block. ca. Signs of methemoglobinemia may occur immediately or may be delayed some hours after exposure, and are characterized by a cyanotic skin discoloration and/or abnormal coloration of the blood. Babies so affected present with unexplained neonatal depression at birth, which correlates with high local anesthetic serum levels, and often manifest seizures within six hours. It is available in plasters (or patches), sprays, and creams, as topical lidocaine. 2007 Sep;51(8):1005-15; discussion 1016-7. doi: 10.1111/j.1399-6576.2007.01401.x. The dosages suggested in this table are for normal healthy adults and refer to the use of epinephrine-free solutions. Lidocaine for spinal anesthesia. Because many drugs are excreted in human milk, caution should be exercised when Lidocaine HCl is administered to a nursing woman. Table 1 (Recommended Dosages) summarizes the recommended volumes and concentrations of Lidocaine HCl Injection, USP for various types of anesthetic procedures. This means that it reduces sensation or pain in the area of the body where it is injected and does not affect other areas. There are, however, no adequate and well-controlled studies in pregnant women. Small doses of local anesthetics injected into the head and neck area, including retrobulbar, dental and stellate ganglion blocks, may produce adverse reactions similar to systemic toxicity seen with unintentional intravascular injections of larger doses. The pharmacological/toxicological actions of these metabolites are similar to, but less potent than, those of Lidocaine HCl. Die einseitige Spinalanästhesie ist ein kostengünstiges und schnell durchführbares Verfahren. The first consideration is prevention, best accomplished by careful and constant monitoring of cardiovascular and respiratory vital signs and the patient’s state of consciousness after each local anesthetic injection. Dosage recommendations should not be exceeded (see DOSAGE AND ADMINISTRATION). The pH of this solution is adjusted to approximately 6.5 (5.0 to 7.0) with sodium hydroxide and/or hydrochloric acid. Lidocaine HCl is metabolized rapidly by the liver, and metabolites and unchanged drug are excreted by the kidneys. Lidocaine HCl should also be used with caution in patients with severe shock or heart block. When appropriate, patients should be informed in advance that they may experience temporary loss of sensation and motor activity, usually in the lower half of the body, following proper administration of epidural anesthesia. Thus, the use of this enzyme determination, without isoenzyme separation, as a diagnostic test for the presence of acute myocardial infarction may be compromised by the intramuscular injection of Lidocaine HCl. Br J Anaesth in press]. In a prospective review of 10,440 patients who received Lidocaine HCl for spinal anesthesia, the incidences of adverse reactions were reported to be about 3 percent each for positional headaches, hypotension and backache; 2 percent for shivering; and less than 1 percent each for peripheral nerve symptoms, nausea, respiratory inadequacy and double vision. Lidocaine has been extensively used for spinal anesthesia when relatively short duration is required. Lidocaine HCl Injection, USP solution contains Lidocaine HCl, which is chemically designated as acetamide, 2-(diethylamino)-N-(2,6-dimethylphenyl)-, monohydrochloride and has the molecular wt. Journal of Clinical Anesthesia. Persistent motor, sensory and/or autonomic (sphincter control) deficit of some lower spinal segments with slow recovery (several months) or incomplete recovery have been reported in rare instances when caudal or lumbar epidural block has been attempted. Intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures is an unapproved use, and there have been post-marketing reports of chondrolysis in patients receiving such infusions. Supportive treatment of circulatory depression may require administration of intravenous fluids and, when appropriate, a vasopressor as directed by the clinical situation (eg, ephedrine). Local anesthetic solutions containing antimicrobial preservatives (eg, methylparaben) should not be used for epidural or spinal anesthesia because the safety of these agents has not been established with regard to intrathecal injection, either intentional or accidental. The use of even more dilute solutions (ie, 0.25 to 0.5%) and total dosages not to exceed 3 mg/kg (1.4 mg/lb) are recommended for induction of intravenous regional anesthesia in children. Animal reproduction studies are not always predictive of human response. Durch Techniken mit niedrig dosierten (hyperbaren) konventionellen Lokalanästhetika, durch die Technik der unilateralen Spinalanästhesie, aber vor allem durch z.T. Concurrent administration of vasopressor drugs (for the treatment of hypotension related to obstetric blocks) and ergot-type oxytocic drugs may cause severe, persistent hypertension or cerebrovascular accidents. Lidocaine adalah obat untuk menghilangkan rasa sakit atau memberi efek mati rasa pada bagian tubuh tertentu (obat bius lokal). Information derived from diverse formulations, concentrations and usages reveals that Lidocaine HCl is completely absorbed following parenteral administration, its rate of absorption depending, for example, upon various factors such as the site of administration and the presence or absence of a vasoconstrictor agent. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Voit tarvita sitä myöhemmin. Obat ini juga bisa digunakan untuk mengatasi aritmia jenis tertentu, sehingga termasuk juga dalam golongan obat antiaritmia. There have been adverse event reports of chondrolysis in patients receiving intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures. These may include spinal block of varying magnitude (including total spinal block), hypotension secondary to spinal block, loss of bladder and bowel control, and loss of perineal sensation and sexual function.

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