Lidocaína Fresenius Kabi (Lidocaine Hydrochloride Monohydrate)

Lidocaine is used in several clinical settings that involve nerve conduction blockade.

• Minor surgical procedures: provides local anesthesia to enable painless incision and manipulation.
• Epidural anesthesia: produces segmental sensory and motor block for obstetric or postoperative pain control.
• Intravenous regional anesthesia (Bier block): creates a reversible nerve block for limb surgeries.
• Ventricular arrhythmias: stabilizes cardiac membrane excitability to treat life‑threatening rhythm disturbances.
• Dental procedures: offers topical anesthesia for tooth extractions and periodontal work.

• Lidocaine blocks voltage‑gated sodium channels on neuronal membranes, preventing the rapid influx of sodium ions required for depolarization. By stabilizing the neuronal membrane, it inhibits initiation and propagation of action potentials, resulting in loss of sensation in the targeted area. The same sodium‑channel blockade in cardiac tissue reduces abnormal automaticity, contributing to its anti‑arrhythmic effect.

Lidocaine may cause a range of adverse reactions, from mild to severe, depending on dose and administration route.

Common Side Effects

• Tingling or numbness at the injection site
• Metallic taste
• Dizziness

Serious or Rare Side Effects

• Cardiac arrhythmias or cardiac arrest
• Seizures
• Severe allergic reaction (anaphylaxis)

When using lidocaine, clinicians should observe several safety measures.

• Assess patient allergy: verify no known hypersensitivity to lidocaine or amide‑type anesthetics.
• Evaluate cardiac status: avoid use in patients with severe conduction disorders or recent myocardial infarction.
• Monitor plasma levels: consider reduced dosing in hepatic impairment due to slower metabolism.
• Use caution in the elderly: age‑related physiological changes may increase sensitivity.
• Avoid concurrent use of other sodium‑channel blockers: risk of additive cardiotoxicity.
• Store below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Lidocaine can interact with several medicines, requiring careful assessment.

Major Interactions (Avoid)

• Class I antiarrhythmics (e.g., quinidine, procainamide): may cause severe cardiotoxicity.
• Beta‑blockers (e.g., propranolol): can enhance bradycardia and hypotension.
• CYP3A4 inhibitors (e.g., ketoconazole): increase lidocaine plasma concentrations.

Moderate Interactions (Monitor Closely)

• CYP1A2 inducers (e.g., rifampin): may reduce lidocaine effectiveness.
• Concurrent use of other local anesthetics: additive toxicity risk.
• Diuretics (e.g., furosemide): may alter plasma protein binding and affect levels.