BNF for Children (BNFC) 2018-2019

Anaesthesia in dental practice

▶TO MUCOUS MEMBRANES USING DENTAL GEL

▶Child 4–17 years:Apply 100 – 500 mg, use cotton pellet

for application to dried mucosa, dose expressed as

weight of gel

DOSE EQUIVALENCE AND CONVERSION

▶ 1 metered dose ofXylonor®spray is equivalent to 10 mg

of lidocaine.

▶ 2 millimetres ofXylonor®gel is approximately

equivalent to 100 mg of gel (approximately equivalent

to 5 mg of lidocaine).

lCAUTIONSSepsis (risk of rapid systemic absorption).

traumatised mucosa (risk of rapid systemic absorption)

lINTERACTIONS→Appendix 1 : antiarrhythmics

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Oromucosal gel

▶Xylonor(Septodont Ltd)

Cetrimide 1.5 mg per 1 gram, Lidocaine 50 mg per 1 gramXylonor

5 % gel sugar-free| 15 gramP£ 4. 00

Spray

▶Xylonor(Septodont Ltd)

Cetrimide 100 microgram per 1 gram, Lidocaine 10 mg per

1 gramXylonor 10 % spray sugar-free| 36 gramP£ 20. 15

Lidocaine with phenylephrine

The properties listed below are those particular to the

combination only. For the properties of the components

please consider, lidocaine hydrochloride p. 826 ,

phenylephrine hydrochloride p. 125.

lINDICATIONS AND DOSE

Anaesthesia before nasal surgery, endoscopy,

laryngoscopy, or removal of foreign bodies from the nose

▶BY INTRANASAL ADMINISTRATION

▶Child 12–17 years:Up to 8 sprays

lINTERACTIONS→Appendix 1 : antiarrhythmics.

sympathomimetics, vasoconstrictor

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Spray

▶Lidocaine with phenylephrine (Non-proprietary)

Phenylephrine hydrochloride 5 mg per 1 ml, Lidocaine

hydrochloride 50 mg per 1 mlLidocaine 5 % / Phenylephrine 0. 5 %

nasal spray| 2. 5 mlP£ 12. 90 DT = £ 12. 90

Lidocaine with prilocaine 14-Jun-2017

The properties listed below are those particular to the

combination only. For the properties of the components

please consider, lidocaine hydrochloride p. 826 , prilocaine

hydrochloride p. 829.

lINDICATIONS AND DOSE

Anaesthesia before minor skin procedures including

venepuncture

▶TO THE SKIN

▶Neonate:Apply up to 1 g for maximum 1 hour before

procedure, to be applied under occlusive dressing,

shorter application time of 15 – 30 minutes is

recommended for children with atopic dermatitis

( 30 minutes before removal of mollusca); maximum

1 dose per day.

▶Child 1–2 months:Apply up to 1 g for maximum 1 hour

before procedure, to be applied under occlusive

dressing, shorter application time of 15 – 30 minutes is

recommended for children with atopic dermatitis

( 30 minutes before removal of mollusca); maximum

1 dose per day

▶Child 3–11 months:Apply up to 2 g for maximum 1 hour

before procedure, to be applied under occlusive

dressing, shorter application time of 15 – 30 minutes is

recommended for children with atopic dermatitis

( 30 minutes before removal of mollusca); maximum

2 doses per day

▶Child 1–11 years:Apply 1 – 5 hours before procedure, a

thick layer should be applied under occlusive dressing,

shorter application time of 15 – 30 minutes is

recommended for children with atopic dermatitis

( 30 minutes before removal of mollusca); maximum

2 doses per day

▶Child 12–17 years:Apply 1 – 5 hours before procedure

( 2 – 5 hours before procedures on large areas e.g. split

skin grafting), a thick layer should be applied under

occlusive dressing, shorter application time of

15 – 30 minutes is recommended for children with

atopic dermatitis ( 30 minutes before removal of

mollusca)

Anaesthesia on genital skin before injection of local

anaesthetics

▶TO THE SKIN

▶Child 12–17 years:Apply under occlusive dressing for

15 minutes (males) or 60 minutes (females) before

procedure

Anaesthesia before surgical treatment of lesions on

genital mucosa

▶TO THE SKIN

▶Child 12–17 years:Apply up to 10 g, to be applied

5 – 10 minutes before procedure, maximum dose should

be proportionally reduced in adolescents with body-

weight less than 20 kg

Anaesthesia before cervical curettage

▶TO THE SKIN

▶Child 12–17 years:Apply 10 g in lateral vaginal fornices

for 10 minutes

lCONTRA-INDICATIONSUse in child less than 37 weeks

corrected gestational age

lINTERACTIONS→Appendix 1 : anaesthetics, local.

antiarrhythmics

lPATIENT AND CARER ADVICE

Medicines for Children leaflet: EMLA cream for local

anaesthesiawww.medicinesforchildren.org.uk/emla-cream-for-

local-anaesthesia

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug.

Cream

▶Lidocaine with prilocaine (Non-proprietary)

Lidocaine 25 mg per 1 gram, Prilocaine 25 mg per

1 gramLidocaine 2. 5 % / Prilocaine 2. 5 % cream| 5 gramps

▶Denela(Teva UK Ltd)

Lidocaine 25 mg per 1 gram, Prilocaine 25 mg per 1 gramDenela

5 % cream| 5 gramp£ 2. 84 – £ 3. 29 | 25 gramp£ 12. 99 |

30 gramp£ 14. 75 DT = £ 12. 30

▶Emla(Aspen Pharma Trading Ltd)

Lidocaine 25 mg per 1 gram, Prilocaine 25 mg per 1 gramEmla

5 % cream| 5 gramp£ 2. 25 – £ 2. 99 | 25 gramp£ 11. 70 |

30 gramp£ 12. 30 DT = £ 12. 30

▶Nulbia(Glenmark Pharmaceuticals Europe Ltd)

Lidocaine 25 mg per 1 gram, Prilocaine 25 mg per 1 gramNulbia

5 % cream| 5 gramp£ 1. 58 | 25 gramp£ 7. 88 | 30 gramp

£ 8. 61 DT = £ 12. 30

828 Local anaesthesia BNFC 2018 – 2019

Anaesthesia

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