Managing Complications in Pregnancy and Childbirth: - IAWG

Anaesthesia and analgesiaC-41TABLE C-4Maximum safe doses of local anaesthetic drugsDrugMaximum Dose(mg/kg of body weight)Maximum Dose for60 kg Adult (mg)Lignocaine 4 240Lignocaine + adrenaline1:200 000 (5 mcg/mL)7 420• Inject slowly.• Avoid accidental injection into a vessel. There are three ways ofdoing this:- moving needle technique (preferred for tissue infiltration): theneedle is constantly in motion while injecting; this makes itimpossible for a substantial amount of solution to enter avessel;- plunger withdrawal technique (preferred for nerve block whenconsiderable amounts are injected into one site): the syringeplunger is withdrawn before injecting; if blood appears, theneedle is repositioned and attempted again;- syringe withdrawal technique: the needle is inserted and theanaesthetic is injected as the syringe is being withdrawn.To avoid lignocaine toxicity:C use a dilute solution;C add adrenaline when more than 40 mL will be used;C use lowest effective dose;C observe maximum dose;C avoid IV injection.DIAGNOSIS OF LIGNOCAINE ALLERGY AND TOXICITYTABLE C-5Symptoms and signs of lignocaine allergy and toxicity