Lignocaine

Question 1

Lignocaine
Type

Answer 1

Antiarrhythmic and local anaesthetic agent

Question 2

Lignocaine
Action

Answer 2

Blocks sodium channels reducing ventricular excitability and pain transmission

Question 3

Lignocaine
Route Onset Peak Duration
IV

Answer 3

Lignocaine
Route Onset Peak Duration
IV 1-4min 5-10min 20min

Question 4

Lignocaine
Uses 4

Answer 4

C3 - Cardiac Arrest
C17 - Torsades de Pointes
Post intraosseous procedure pain (2% preparation only)
Local anaesthesia of the skin prior to cannulation (1% preparation only)

Question 5

Lignocaine
Adverse Effects

Answer 5

Lignocaine may cause or exacerbate ventricular dysrhythmias
In high doses, may cause:
*Neurological side effects (drowsiness, disorientation, agitation, muscle twitching, fits and coma)
*Cardiac effects (hypotension, bradycardia, heart block(s) and asystole)

Question 6

Lignocaine
Contraindications 1

Answer 6

Allergy or hypersensitivity to lignocaine

Question 7

Lignocaine
2 indications

Answer 7

1. VF or PULSELESS VT and Torsades de Pointes
   VF - VT: Unresponsive to amiodarone
2. POST INTRAOSSEOUS PROCEDURE PAIN
   Localised pain post intraosseous insertion. Note: Allow 1 minute to allow for effect once lignocaine is introduced into the medullary
   space

Question 8

Lignocaine
VF or Pulseless VT and Torsades de Pointes
Dose Adult (16 or older)

Answer 8

IV 100mg (lignocaine 2%) bolus (1 ampuole)
Repeat Once
Max Dose 200mg

Question 9

Lignocaine
VF or Pulseless VT and Torsades de Pointes
Dose Paed (under 16)

Answer 9

IV/IO 1mg/kg (lignocaine 2%) (Max bolus: 100mg) Repeat Once
Max Dose 2mg/kg (up to 200mg)

Question 10

Lignocaine
Post Intraosseous Procedure Pain
Dose Adult (16 and older)

Answer 10

IO 40mg (lignocaine 2%) slow infusion (2ml of 5ml ampuole)
Nil Repeat
Max Total 40mg

Question 11

Lignocaine
Post Intraosseous Procedure Pain
Dose Paed (under 16)

Answer 11

IO 0.5mg/kg (lignocaine 2%) (max bolus 40mg) slow infusion
Nil Repeat
Max Total 0.5mg/kg (max 40mg)