Lignocaine Adrenaline Injection

Lignocaine (Lidocaine) Hydrochloride: A local anesthetic. Lignocaine Adrenaline Injection, Local Anesthetic Injection, Anesthetic Solution with Epinephrine

Adrenaline (Epinephrine): A vasoconstrictor.

A typical formulation might contain:

Lignocaine 1% or 2% (10–20 mg/mL)

Adrenaline 1:100,000 or 1:200,000 (0.01–0.005 mg/mL)

Mechanism of Action
Lignocaine:
Blocks voltage-gated sodium channels in nerve membranes.

Prevents nerve impulse conduction, causing local anesthesia.

Adrenaline:
Stimulates α-adrenergic receptors causing vasoconstriction.

Local Anesthetic Injection

This:

Prolongs anesthetic effect by reducing blood flow.

Reduces bleeding at the site.

Delays systemic absorption of lignocaine (reduces toxicity).

Indications / Uses
Local Anesthesia:

Dental procedures

Minor surgical interventions

Skin and soft tissue infiltration

Obstetric and gynecologic procedures (with caution)

ENT, ophthalmologic, and orthopedic uses

Nerve Blocks:

Peripheral nerve blocks

Epidural (careful formulation without preservatives)

Lignocaine Adrenaline Injection

Hemostasis:

Used where bleeding control is essential due to vasoconstriction effect

Contraindications
Known hypersensitivity to amide-type local anesthetics or adrenaline.

Peripheral vascular disease (risk of tissue ischemia)

Areas supplied by end arteries (e.g., fingers, toes, ears, nose, penis)

Severe hypertension, cardiac arrhythmias, or ischemic heart disease

Hyperthyroidism or pheochromocytoma

Local Anesthetic Injection

Dosage and Administration
Dosage (Adults)
Route Lignocaine Max Dose (with Adrenaline)
Infiltration / Nerve Block 7 mg/kg (not to exceed 500 mg total)

Always adjust for weight, age, and comorbidities. Anesthetic Solution with Epinephrine

Onset: 2–5 minutes

Duration: 1–3 hours (longer with adrenaline)

Example for dental block:

2% lignocaine with 1:100,000 adrenaline – 1.8–3.6 mL per block

Pediatric Dose:
3–5 mg/kg (lignocaine with adrenaline) – more conservative approach

Side Effects / Adverse Reactions
From Lignocaine:
CNS toxicity (dizziness, tinnitus, seizures)

Cardiovascular depression (hypotension, bradycardia, arrhythmias)

Lignocaine Adrenaline Injection

From Adrenaline:
Palpitations

Anxiety or restlessness

Hypertension

Cardiac arrhythmias

Precautions
Monitor cardiac function and vital signs during administration.

Avoid repeated dosing in short intervals.

Ensure aspiration before injection to avoid intravascular injection.

Use with caution in elderly or those with hepatic impairment.

Be wary in patients on beta-blockers, tricyclic antidepressants, or MAO inhibitors.

Drug Interactions
Beta-blockers: Risk of hypertensive reaction

MAO inhibitors / TCAs: Potentiate adrenaline effects

Antiarrhythmic drugs: May increase lignocaine toxicity

Lidocaine Epinephrine Injection

Special Warnings
Avoid using in terminal vascular field areas (e.g., digits, penis, ears) due to ischemic necrosis risk.

Not recommended for IV regional anesthesia (Bier block) due to risk of systemic toxicity.

Storage
Store between 15–25°C

Protect from light

Discard any discolored solution or if precipitate forms

Available Forms
1% or 2% Lignocaine with 1:100,000 or 1:200,000 Adrenaline

Packaging: Ampoules or vials (e.g., 2 mL, 5 mL, 10 mL)

Benefits
Enhanced anesthetic duration

Reduced bleeding in operative field

Decreased systemic lignocaine toxicity

Risks
Ischemia in extremities

Cardiotoxicity if overdosed

Drug interactions and CNS effects

Lidocaine Epinephrine Injection

Veterinary Use
Used similarly for local anesthesia in small animals and sometimes large animals for minor procedures.

Avoid in end-artery areas (ears, tails, claws).

Dosage should be strictly weight-adjusted.