Before Using This Medicine
Lidocaine Hydrochloride injection, for infiltration and nerve block, should only be
used by clinicians who are well versed in diagnosis and management of dose-related
toxicity and other acute emergencies that might arise from the block to be employed.
You must ensure that the immediate availability of oxygen, and other resuscitative
drugs, cardiopulmonary equipment, and the personnel needed for proper management of
toxic reactions and related emergencies are in place.
Delay in proper management
of dose-related toxicity, underventilation from any cause and/or altered sensitivity
may lead to the developement of acidosis, cardiac arrest, and possibly death.
To avoid intravascular injection, aspiration should be performed before the local
anesthetic solution is injected. The needle must be repositioned until no return of
blood can be elicited by aspiration. Note, however, that the absence of blood in the
syringe does not guarantee that intravascular injection has been avoided.
Local anesthetic solutions containing antimicrobial preservatives (e.g.,
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.