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동물 종별 용량

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금기

• Known hypersensitivity to amide-class local anesthetics
• Severe SA, AV, or intraventricular heart block (unless artificially paced)
• Adams-Stokes syndrome
• Intravenous use of lidocaine products containing epinephrine
• Continuous rate infusion (CRI) in cats during the perioperative period (due to negative haemodynamic effects)
• Intravenous administration of lidocaine solutions containing adrenaline
• Use of adrenaline-containing solutions for complete ring block of an extremity (danger of ischaemic necrosis)

이상반응

• CNS toxicity (dose-related): drowsiness, depression, ataxia, nystagmus, muscle tremors, seizures
• Gastrointestinal: nausea and vomiting (usually transient)
• Cardiovascular: hypotension (especially with rapid IV bolus), bradycardia, PR and QRS interval prolongation, circulatory collapse at toxic doses
• Cats: heightened risk of severe cardiodepression and CNS signs
• Depression
• Seizures
• Muscle fasciculations
• Vomiting
• Bradycardia
• Hypotension
• Laryngeal oedema (in cats, associated with CFC propellants in unlicensed aerosols)

약물 상호작용

• Gas Anesthetics (Isoflurane, Sevoflurane) · Lidocaine infusions reduce MAC requirements. Additive cardiodepression may occur, especially in cats.
• Other Antiarrhythmics (Procainamide, Quinidine, Propranolol) · May cause additive or antagonistic cardiac effects; enhanced risk of toxicity.
• Cimetidine · May decrease lidocaine clearance, increasing lidocaine levels and effects. · moderate
• Furosemide · Diuretic-induced hypokalemia may reduce the antiarrhythmic efficacy of lidocaine.
• Phenobarbital / Phenytoin · May induce hepatic enzymes, increasing lidocaine metabolism and decreasing its serum levels.
• Propranolol · May decrease hepatic blood flow and lidocaine clearance, increasing lidocaine levels. · moderate
• Succinylcholine · Large doses of lidocaine may prolong succinylcholine-induced apnea.
• Other antiarrhythmics · May cause increased myocardial depression · major

모니터링

• Continuous ECG monitoring (especially during IV bolus or CRI)
• Signs of CNS toxicity (ataxia, tremors, seizures)
• Blood pressure (monitor for hypotension)
• Serum lidocaine levels if available (Therapeutic range: 1-6 micrograms/mL)
• ECG (especially during IV therapy for arrhythmias)
• Blood pressure
• Heart rate
• CNS signs (monitor for fasciculations or seizures)

과용량

In dogs, toxicity may result if serum levels exceed **8 micrograms/mL**. * **Clinical Signs:** Ataxia, nystagmus, depression, seizures, bradycardia, hypotension, and at very high levels, circulatory collapse. * **Management:** Because lidocaine is rapidly metabolized, simply stopping the infusion or reducing the rate (with close monitoring) is often sufficient for minor signs. * **Seizure Control:** Treat seizures or excitement with **diazepam** or a short/ultrashort-acting barbiturate. > **Warning:** Longer-acting barbiturates (e.g., pentobarbital) should be avoided. * **Cardiovascular Support:** Treat circulatory depression with IV fluids, pressor agents, and initiate CPR if necessary.