Lidocaine (Xylocaine) Nursing Considerations

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Generic Name


Trade/Brand Name



  • Surgical procedures required local or regional anesthetic
  • Treatment of irregular heart rhythms in emergency situations


  • Blocks influx of sodium ions into surrounding membranes
  • Prevents conduction of impulses along nerve

Therapeutic Class

  • Local anesthetic
  • Regional anesthetic
  • Antiarrhythmic – Class 1b

Pharmacologic Class

Amide anesthetic

Nursing Considerations

  • Use caution in patients with hepatic disease
    • Effects prolonged
  • Do not use with
    • Severe heart block
    • Wolff-Parkinson-White syndrome
    • Stokes-Adam syndrome
    • Allergy
  • Signs of overdose
    • Nervousness
    • Double vision
    • Tremors
    • Confusion
  • May interact with beta blockers
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Hey guys, let’s talk about lidocaine also known as XCA. This is an injectable medication, as you can see here. And it also comes in other forms like topical jelly creams, and can also be used orally. So for lidocaine, it works in the body as a local anesthetic, a regional anesthetic, and also as an anti arrhythmic, typically in emergency situations. So the pharmacologic class or the chemical effect it has in the body is an AMI anesthetic. So lidocaine by blocking the influx of sodium into surrounding membranes, which prevents the conduction of impulses along a nerve, which hence causes numbness. So we use lidocaine for local or regional anesthesia for surgical procedures and also for irregular heart rhythms. So with lidocaine, we can see some side effects, things like drowsiness, dizziness, vomiting, and sometimes ringing in the ears or tinnitus. The tinnitus typically has to do with too much Lido. 

So let’s take a look at a few nursing considerations for lidocaine. The use of lidocaine should be cautioned in patients with hepatic disease. Lidocaine should not be used in patients who have severe heart block who have Wolf Parkinson, white syndrome or Stokes atom syndrome. And of course it should not be use in patients with an allergy signs of toxicity for lidocaine include things like confusion, nervousness, tremors, double vision. And remember, I just mentioned that tinnitus, so lidocaine can interact with beta blockers. So keep that in mind and teach patients to grapefruit juice. And if lidocaine is used orally, they should not eat for at least one hour after to prevent any issues. So guys, as a surgical nurse, we use lidocaine all the time. I mean, multiple times a day, lidocaine can come epinephrine. It also can come without ene. And this is important as a surgical nurse because some of the AR areas of the body can’t handle the epinephrine or could cause issues. But in general, the use of local anesthesia, like lidocaine is super beneficial for surgical patients. And it does last for a while after the procedure. And it’s really helpful to them. 

That’s it for lidocaine or can now go out and be your best self today and as always happy nursing.

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