The amount of solution and the total dose of lidocaine depends on the type of anesthesia, the nature and duration of the surgery.
The method of diluting 20 mg / ml (2%) of lidocaine solution to obtain a solution of the required concentration:
To prepare 10 mg / ml (1%) solution of lidocaine it is necessary to take 1 part of 20 mg / ml lidocaine solution and 1 part water for injection, i.e. mix 2 ml of 20 mg / ml lidocaine solution with 2 ml water for injection (for a 2 ml ampoule) or mix 5 ml of 20 mg / ml lidocaine solution with 5 ml water for injection (for a 5 ml ampoule).
To prepare 5 mg / ml (0.5%) solution of lidocaine it is necessary to take 1 part of 20 mg / ml lidocaine solution and 3 parts water for injection, i.e. mix 2 ml of 20 mg / ml lidocaine solution with 6 ml of water for injection (for a 2 ml ampoule) or mix 5 ml of 20 mg / ml lidocaine solution with 15 ml of water for injection (for a 5 ml ampoule).
To prepare a 2.5 mg / ml (0.25%) solution of lidocaine must take 1 part 20 mg / ml of lidocaine and 7 parts of water for injection, t. e. mixing 2 ml of 20 mg / ml lidocaine solution with 14 ml of water for injections (to ampoules of 2 ml) or mixed with 5 ml of 20 mg / ml lidocaine solution with 35 ml water for injection (for a 5 ml ampoule).
To prepare 1.25 mg / ml (0.125%) solution of lidocaine must take 1 part 20 mg / ml of lidocaine and 15 parts of water for injection, t. e. mixing 2 ml of 20 mg / ml lidocaine solution with 30 ml of water for injections (to ampoules of 2 ml) or mixed with 5 ml of 20 mg / ml lidocaine solution with 75 ml water for injection (for a 5 ml ampoule).
For infiltration anesthesia (intradermally, subcutaneously) 0.125%, 0.25%, 0.5% solutions are used; To achieve infiltration anesthesia, up to 60 ml (5-300 mg) of a 0.5% solution or up to 30 ml of a 1% solution is used.
For conductive anesthesia (anesthesia of the peripheral nerves, including when blocking the nerve plexuses) apply 1 and 2% solutions; the maximum total dose is up to 400 mg (40 ml of a 1% solution or 20 ml of a 2% solution). For blockade of nerve plexuses, 10-20 ml of a 1% solution or 5-10 ml of a 2% solution.
For conductive anesthesia of peripheral nerves: humerus - 15-20 ml (225-300 mg) of 1.5% solution; in dental practice - 1-5 ml (20-100 mg) of 2% solution; blockade of intercostal nerves - 3 ml (30 mg) of 1% solution.
For paracervical anesthesia: 10 ml (100 mg) of 1% solution in each direction, if necessary, repeated administration is possible after at least 1.5 hours.
For paravertebral anesthesia: 3 to 5 ml (30-50 mg) of 1% solution. Retrobulbar anesthesia - 3.0-4.0 (60-80 mg) of a 2% solution.
Parabulbar anesthesia 1.0-2.0 (20-40 mg) of a 2% solution. Vagosimpathetic blockade: cervical (stellate) node - 5 ml (50 mg) of 1% solution, lumbar - 5-10 ml (50-100 mg) of 1% solution.
Spinal anesthesia - 3,0-4,0 ml (60-80 mg) of 2% solution.
Epidural anesthesia - for the preparation of analgesia 25-30 ml (250-300 mg) of 1% solution is used; to obtain anesthesia 15-20 ml (225-300 mg) of a 1.5% solution or 10-15 ml (200-300 mg) of a 2% solution; for thoracic epidural anesthesia - 20-30 ml (200-300 mg) of 1% solution.It is not recommended to use continuous administration of anesthetic with a catheter; the maximum dose should not be repeated more than 90 minutes later.
When using caudal anesthesia: in surgical practice - 15-20 ml (225-300 mg) of 1.5% solution. It is not recommended to use continuous administration of anesthetic with a catheter; the maximum dose should not be repeated more than 90 minutes later. Recommended doses for children with neuromuscular blockade to 4.5 mg / ml 0.25-1.0% solution.
The maximum dose for children is 4.5 mg / kg, but not more than 100 mg; the maximum dose for adults is not more than 4.5 mg / kg or 300 mg. These doses should be repeated within 24 hours.
The effect of lidocaine can be prolonged by the addition of a 0.1% solution of epinephrine (0.1 ml per 20 ml of lidocaine). In this case, with regional anesthesia, the dose of lidocaine can be increased to 600 mg.
The procedure for working with a polymer ampoule:
1. Take the ampoule and shake it, holding it by the neck.
2. Press the ampoule with your hand, while the drug should not be isolated, and turn and separate the valve with rotating movements.
3.After the opening, immediately connect the syringe with the ampoule.
4. Turn over the ampoule and slowly fill the syringe with its contents.
5. Put the needle on the syringe.