For infiltration anesthesia: intramuscularly, intradermally, subcutaneously. Apply a solution of lidocaine 5 mg / ml (maximum dose of 400 mg).
For blockade of peripheral nerves and nerve plexuses: perineural, 10-20 ml of a solution of 10 mg / ml or 5-10 ml of a solution of 20 mg / ml (not more than 400 mg).
For conductive anesthesia: perineurally apply solutions of 10 mg / ml and 20 mg / ml (not more than 400 mg).
For epidural anesthesia: epidurally, solutions of 10 mg / ml or 20 mg / ml (not more than 300 mg).
For spinal anesthesia: subarachnoid, 3-4 ml of a solution of 20 mg / ml (60-80 mg). Parabulbar anesthesia: parabulbar, 1-2 ml of lidocaine 20 mg / ml. Retrobulbaric anesthesia: retrobulbarno, 3-4 ml of a solution of lidocaine 20 mg / ml. Subconjunctival anesthesia: injection under the conjunctiva, 0.5-1 ml of lidocaine solution 20 mg / ml.
To lengthen the action of lidocaine, it is possible to add ex tempore 0.1% solution of epinephrine (adrenaline) (1 drop per 5-10 ml of lidocaine solution, but not more than 5 drops for the entire volume of the solution).
It is recommended to reduce the dose of lidocaine in elderly patients and patients with liver diseases (cirrhosis, hepatitis) or with reduced hepatic blood flow (chronic heart failure) by 40-50%.
With chronic renal failure, dose adjustment is not required.
For children with local anesthesia, the maximum dose in newborns is 4 mg / kg, in children over 1 year - 5-7 mg / kg.
Lidocaine solution with a concentration of 100 mg / ml can be used only after dilution.
As an antiarrhythmic drug: intravenously, 25 ml of a solution of 100 mg / ml, 100 ml of 0.9% sodium chloride solution should be diluted to a lidocaine concentration of 20 mg / ml. This diluted solution is used to administer a loading dose. The administration begins with a loading dose of 1 mg / kg (for 2-4 minutes at a rate of 25-50 mg / min) with immediate connection of a constant infusion at a rate of 1-4 mg / min. Due to the rapid distribution (half-life of about 8 minutes), 10-20 minutes after the first dose, the drug concentration in the blood plasma decreases, which may require a repeated bolus administration (against a background of constant infusion) at a dose of 1 / 2-1 / 3 loading dose, with an interval of 8-10 minutes. The maximum dose at 1 hour is 300 mg, per day 2000 mg.
Intravenous infusion is usually performed for 12-24 hours with constant ECG monitoring, after which the infusion is stopped to assess the need for changing antiarrhythmic therapy in the patient.
Intravenously sprayed children - 1 mg / kg (usually 50-100 mg) as a loading dose at a rate of 25-50 mg / min (ie within 3-4 minutes); if necessary, the dose is repeated after 5 minutes, after which a continuous infusion is prescribed.Intravenously in the form of continuous infusion (usually after a loading dose): the maximum dose for children is 30 mcg / kg / min.