Xylocaine Pump Spray Special Precautions

Excessive dosage or short intervals between doses may result in high plasma levels and serious adverse effects. Absorption from mucous membranes is variable but is especially high from the bronchial tree. Lidocaine spray should be used with caution in patients with wounds or traumatized mucosa in the region of the proposed application. A damaged mucosa will permit increased systemic absorption. The management of serious adverse reactions may require the use of resuscitative equipment, oxygen and other resuscitative drugs. (See Overdosage.)
In paralysed patients under general anaesthesia, higher blood concentrations may occur than in spontaneously breathing patients. Unparalysed patients are more likely to swallow a large proportion of the dose which then undergoes considerable first-pass hepatic metabolism following absorption from the gut.
The oropharyngeal use of topical anaesthetic agents may interfere with swallowing and thus enhance the danger of aspiration. Numbness of the tongue or buccal mucosa may increase the danger of biting trauma.
If the dose or administration is likely to result in high blood levels, some patients require special attention to prevent potentially dangerous side effects: Patients with partial or complete heart block; elderly and patients in poor general health; patients with advanced liver disease or severe renal dysfunction.
Avoid contact with the eyes.
Patients treated with antiarrhythmic drugs class III (eg, amiodarone) should be under close surveillance and ECG monitoring considered, since cardiac effects may be additive.
Xylocaine Pump Spray should not be used on cuffs of endotracheal tubes (ETT) made of plastic. Lidocaine base in contact with both PVC and non-PVC cuffs of endotracheal tubes may cause damage of the cuff. This damage is described as pinholes, which may cause leakage that could lead to pressure loss in the cuff.
Xylocaine Pump Spray is probably porphyrinogenic and should only be prescribed to patients with acute porphyria on strong or urgent indications. Appropriate precautions should be taken for all porphyric patients.
Effects on the Ability to Drive or Operate Machinery: Depending on the dose, local anaesthetics may have a very mild effect on mental function and may temporarily impair locomotion and coordination.
Use in pregnancy & lactation: It is reasonable to assume that a large number of pregnant women and women of childbearing age have been given lidocaine. No specific disturbances to the reproductive process have so far been reported eg, no increased incidence of malformations.
Like other local anaesthetics, lidocaine may enter the mother's milk, but in such small amounts that there is generally no risk of this affecting the neonate.