Multimodal: Lidocaine

Question 2

A 50 y/o, 60 kg female patient received a Lidocaine initial dose of 1 mg/kg with a subsequent infusion of 1.5 mg/kg/hour for 1.5 hours. How much total Lidocaine in mgs did she receive in the PACU?

Answer 2

60kg x 1 mg/kg = 60 mg
60 kg x 1.5 mg/kg = 90 mg (1 hour)
(60 kg x 1.5mg/kg = 90 mg)/2 = 45 mg (30 minutes)

60+90+45 = 195 mg total!!!

CLASS question

Question 3

Lidocaine plasma concentration of ____ causes what?

1-5 mcg/ml = ?

5-10 mcg/ml = ?

Answer 3

1-5 = analgesia

5-10 = circum-oral numbness; tinnitus; skeletal muscle twitching; systemic HYPOtension; myocardial depression

S45

Question 4

Lidocaine plasma concentration of ____ causes what?

10-15 mcg/ml = ?

15-25 mcg/ml = ?

Answer 4

These are OD levels

10-15 = Sz’s; unconsciousness

15-25 = apnea (pons & medullary depression); coma

S45

Question 5

This med has anti-nociceptive effects by antagonizing the NMDA receptor and “probably” potentiates opioids centrally and peripherally.

Answer 5

Magnesium

S47

Question 6

What are the doses for Lidocaine?
What to monitor for?

Answer 6

Initial bolus = 1 to 2 mg/kg IV over 2 - 4 min

Drip = 1 to 2 mg/kg/hour
terminated at 12-72 hours

monitor: cardiac, hepatic, & renal dysfunction

S44