Lidocaine 1% (10mg/ml) without adrenaline for insertion of SDI 1-2 mlas to insert, 0.5-1 ml to remove - ''below'' distal end of implant
max dose - 4mg/kg - 280mg overall

% solution is g solute in 100 mls solvent

% unionization (lipid solubility) effects speed of onset of action
chemical structure (ester or amide) effects protein binding so duration of action (amide more bound longer acting)
is removed by slow uptake into systemic circulation

CI
not in hypovolaemia, complete heart block, known hypersensitivity

Precautions
membrane stabilizing drug which can cause arrythmymias - beware in renal / hepatic impairment / cardiac conduction impaired, avoid intravascular admin (be sure to aspirate), have resus facility available

Interactions
BB, cimetidine, NA - synergystic
Diazepam - inc risk fits
liver inducers dec efficacy

SE
urticaria - anaphyllaxis
if systemic - blurred vision, tinnitis, circumoral and tongue numbness, then twitching, fits, coma, death
note - giving diazepam concurrently raises threshold for fits so looses sign of gross overdose but if fits give 10mg rectally

Mx reaction
stop giving drug
phone 999
do ABC
give Diazepam if fits