Jan 20, 2023 Viewed: 20

Xylocaine/Local Anesthetics and Antiarrhythmic Drugs

Xylocaine/Local Anesthetics and Antiarrhythmic Drugs


Overview and Efficacy of Xylocaine

Xylocaine is a local anesthetic and antiarrhythmic drug. It is suitable for acute ventricular arrhythmia caused by acute myocardial infarction, surgery, digitalis poisoning and cardiac catheterization, including ventricular premature beats, ventricular tachycardia and ventricular fibrillation. Secondly, it is also used for status epilepticus who are ineffective with other anticonvulsants and local or spinal anesthesia. It can also relieve tinnitus.

 With the in-depth research on Xylocaine, it is found that it also shows good effects in the treatment of other diseases. A summary will be made below.

1.Treatment of vestibular neuritis. Xylocaine can block the excitability of vascular sympathetic nerves, reduce its contraction effect on vascular smooth muscle, relatively enhance the excitability of parasympathetic nerves, and achieve the purpose of improving blood microcirculation. It can improve the blood supply around the vestibular nerve of the inner ear and eliminate the obstruction of endolymphatic reflux. Method: Intravenous injection of 50-100 mg of Xylocaine, and 200-400 mg of intravenous infusion of 5% glucose for severe cases, once a day, 3 days as a course of treatment.

2. To prevent cardiovascular response during tracheal extubation. For endotracheal intubation in patients under general anesthesia, at the end of the operation, the dose of anesthetic should be reduced until the pharyngotracheal reflex is restored. Cardiovascular reactions similar to those during intubation may occur during extubation, and may also cause coughing, which is extremely unfavorable for patients with hypertension, coronary heart disease, and intracranial hypertension. Xylocaine can prevent this reaction, and the usage is intravenous injection of Xylocaine 1.5 mg/kg. Its mechanism is related to central inhibition or inhibition of the heart.

3. Treatment of severe convulsions in newborns. For those with recurrent convulsions, the first loading dose of Xylocaine is 2 mg/kg, plus the initial maintenance dose of 6 mg/kg intravenously per hour, and the dose is gradually reduced within 3 days.

4. It is used for gastroscopy intubation examination. Put 2% Xylocaine into the mouth, swallow slowly for 5 minutes, and perform intubation examination 10 minutes later. Compared with the 2% tetracaine spray method, Xylocaine has the advantages of saving time, convenience, and less pain, and Xylocaine has a sedative effect, which can eliminate the nervousness of patients, reduce gastric juice secretion and gastric peristalsis.

5. Treatment of acute gastrogenic abdominal pain. Acute gastrogenic abdominal pain is mostly caused by acute indigestion, increased gastric acid secretion, mucosal congestion and edema, and even convulsions. Oral Xylocaine can relieve such pain. The usage is 15 mg of 2% Xylocaine orally.

6. Treatment of epilepsy. Xylocaine can pass through the blood-brain barrier, excite and then inhibit the activity of central neurons, and can block the transmission at the junction of nerves and muscles. It has a better effect on status epilepticus. Diluted with 0.1 g of Xylocaine and injected intravenously, the attack will stop immediately, and relapse will still be effective.

7. Treat asthma. Xylocaine is a powerful suppressant of irritating cough and also suppresses bronchial asthma. Method: Xylocaine 5ml (100mg) was atomized and inhaled once a day, and the respiration and heart rate returned to normal, the wheezing sound disappeared, and the arterial blood gas recovery time was significantly shorter than that of the control group.

8. Treatment of hiccups. The mechanism of Xylocaine in treating hiccups may be related to its blocking effect on peripheral and central nerve conduction. Usage: Add 100 mg of Xylocaine into a Murphy's dropper, then add 500 mg of Xylocaine into 10% glucose to maintain intravenous infusion at a rate of 30-40 drops/min. After the hiccup is controlled, keep it for 1-2 days.

9. Treatment of renal colic. Xylocaine has antispasmodic, ureteral dilation and mild analgesic effects, which can relieve renal colic. After diluting with Xylocaine 100 mg, push it intravenously, and then add 200 mg to the infusion for intravenous infusion.

10. There is no inhibitory contraction of the bladder after treatment. Xylocaine can penetrate the mucosa and block the conduction of peripheral nerves, and make a glue for rectal administration, which can block the nerve conduction of detrusor muscle and inhibit the uninhibited contraction of detrusor muscle. Usage: 40 mg of verapamil is administered rectally, and after 5 minutes, 20 ml of 2% Xylocaine is infused into the rectum, and the marked rate (71%) is higher than that of the simple verapamil group (38%).


Dosage of Xylocaine

1. Common Dosage for Adults

①The caudal block is used for labor analgesia, and the dosage is limited to 200mg (1.0%); it can be increased to 200-250mg (1.0-1.5%) for surgical analgesia.

② Epidural block, thoracolumbar segment, 250-300mg (1.5-2.0%).

③ Infiltration local anesthesia or intravenous regional block, 50-200mg (0.25-0.5%).

④Peripheral nerve block, brachial plexus (unilateral) 250-300mg (1.5%); dental, 20-100mg (2.0%); intercostal nerve (each branch), 30mg (1.0%); paracervical infiltration, left and right sides Each 100mg (0.5-1.0%); paravertebral spinal nerve block (each branch), 20-50mg (1.0%); pudendal nerve, each 100mg (0.5-1.0%) on the left and right sides.

⑤ Sympathetic ganglion block, cervical stellate nerve 50mg (1.0%), lumbar 50-100mg (1.0%).

⑥ One-time limit, generally not more than 200mg (4.0mg/kg), and the dosage of epinephrine added to the liquid can be increased to 200-250mg (6.0mg/kg). Intravenous regional block, the maximum dose is 4mg/kg. Intravenous injection of therapeutic drugs, the first initial dose is 1mg/kg, the maximum dose is 4mg/kg, and the adult intravenous infusion is limited to 1mg per minute. Repeated administration of multiple doses, the interval should not be shorter than 60 minutes.

2. Dosage for Children

The usual dosage for children varies with the individual. The maximum total dose of a single administration should not exceed 4.0-4.5mg/kg. 0.25-0.5% solution is commonly used, and 1.0% solution is only used in special cases.



1. Allergy to this product, congestive heart failure, severe myocardial damage, bradycardia, pre-excitation syndrome, liver and kidney dysfunction patients, second and third degree atrioventricular block, history of grand mal seizures, liver function Patients with severe insufficiency and shock are prohibited.

2. Pregnant women and nursing mothers should use it with caution. For those with heart and liver insufficiency, the dosage should be appropriately reduced.

3. Medication for newborns can easily cause poisoning. The half-life of premature infants is about 3.6 hours, which is 1.8 hours longer than that of normal infants. The elderly should adjust the dosage according to the degree of tolerance and needs, and the dosage of patients over 70 years old should be halved.

4. Intravenous injection is limited to antiarrhythmic. For the anesthesia of patients with arteriosclerosis, vasospasm, diabetes and fingers (toes), it is not advisable to add vasoconstrictors (such as epinephrine hydrochloride).

5. Blood pressure, electrocardiogram and serum electrolytes should be checked at any time during the medication. The blood drug concentration should be monitored during long-term medication.


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