Lidocaine Hydrochloride and Epinephrine Injection

1. Introduction of Lignospan standard LIGNOSPAN FORTE and LIGNOSPAN STANDARD are parenterally administered isotonic sterile solutions that contain the local anaesthetic Lidocaine Hydrochloride and the vasoconstrictor Epinephrine (as bitartrate). Single dose cartridges of both solutions contain 1.7 mL. (See INDICATIONS AND USAGE for specific uses). The solutions contain lidocaine hydrochloride, also known as 2-(diethylamino)-N-(2,6-dimethylphenyl)-monohydrochloride or acetamide in chemistry. By using nerve block or infiltration techniques, LIGNOSPAN Solutions are suggested for the creation of local anaesthetic for dental treatments. It is advised to use these approaches only in accordance with approved protocols that are outlined in mainstream textbooks. The amount of LIGNOSPAN (lidocaine HCL and epinephrine) to administer depends on the patient's physical condition, the area of the mouth that needs to be sedated, the vascularity of the oral tissues, and the type of anaesthesia technique being utilised. The smallest amount of solution necessary to produce an effective local anaesthetic should be used; space should be allowed in between injections so that the patient can be watched for signs of a negative reaction. Consult standard textbooks for particular methods and techniques for local anaesthetic in the mouth cavity. LIGNOSPAN STANDARD (lidocaine HCI 2% with a 1:100,000 epinephrine concentration) is preferred for the majority of common dental treatments. However, LIGNOSPAN FORTE (lidocaine HCI 2% with 1:50,000 epinephrine concentration) should be utilised when deeper depth and a more pronounced hemostasis are necessary.

2. Side Effects : Lidocaine side effects are comparable to those seen with other amide-type local anaesthetic drugs in terms of their nature. These unpleasant side effects are typically dose-related and can be brought on by high plasma levels (which can be brought on by excessive dosage, rapid absorption, unintended intravascular injection, or slow metabolic degradation), injection technique, volume of injection, hypersensitivity, individual preferences, or decreased tolerance on the part of the patient. Serious negative events are typically of a systemic nature. The most typical types reported include the following: Central Nervous System : CNS manifestations are excitatory and/or depressant and may be characterized by lightheadedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest. The excitatory manifestations may be very brief or may not occur at all, in which case the first manifestation of toxicity may be drowsiness merging into unconsciousness and respiratory arrest. Drowsiness following the administration of lidocaine is usually an early sign of a high blood level of the drug and may occur as a consequence of rapid absorption. Cardiovascular System : Cardiovascular manifestations in response to lidocaine are usually depressant and are characterized by bradycardia, hypotension, and cardiovascular collapse, which may lead to cardiac arrest.In addition, the beta-adrenergic receptor-stimulating action of epinephrine may lead to excitatory cardiovascular responses, such as tachycardia, palpitations, and hypertension. Signs and symptoms of depressed cardiovascular function may commonly result from a vasovagal reaction, particularly if the patient is in an upright position. Less commonly, they may result from a direct effect of the drug.