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 Formulary Chapter 15: Anaesthesia - Full Chapter
Notes:

Chapter review date:

 Details...
15.02  Expand sub section  Local anaesthesia
15.02  Expand sub section  Articaine
15.02  Expand sub section  Bupivacaine
Bupivacaine hydrochloride (Marcain®)
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Formulary
Red
0.25% and 0.5% injections.
  • DCHFT: 0.5% injection only.
  • RBCH also: Bupivacaine 0.15% in Sodium Chloride 0.9% Epidural Infusion.
  •  
     
    Bupivacaine Hydrochloride with Glucose (Marcain Heavy®)
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    Formulary
    Red
    0.5% Injection. 
     
    Bupivacaine and Adrenaline
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    Formulary
    Red
    Bupivacaine 0.25% + Adrenaline 1 in 200,000 Injection.
    Bupivacaine 0.5% + Adrenaline 1 in 200,000 Injection. 
     
    15.02  Expand sub section  Levobupivacaine
    Chloroprocaine (Ampres®)
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    Formulary
    Red
    Injection.
  • Restricted Item DCHFT: Spinal anaesthesia in adults where the planned surgical procedure should not exceed 40 minutes.
  •  
     
    Levobupivacaine (Chirocaine®)
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    Formulary
    Red
    0.25% and 0.5% injections, 0.125% epidural infusion
     
     
    Controlled Drug Levobupivacaine with Fentanyl
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    Unlicensed Drug Unlicensed
    Red
    Fentanyl 2 micrograms per mL & levobupivacaine 0.1% Epidural infusions.
     
     
    15.02  Expand sub section  Lidocaine to top
    Lidocaine 2% with Chlorhexidine 0.25% (Instillagel®)
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    Formulary
    Green
     
     
    Lidocaine 2.5% with Prilocaine 2.5% (EMLA®)
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    Formulary
    Green
     
     
    Lidocaine 4% cream (LMX 4®)
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    Formulary
    Green

    DCHFT - Paediatrics only. Cannulation in/for theatres.

     
     
    Lidocaine 5% Ointment
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    Formulary
    Green

    For perianal use only


    NB: Sensitisation may occur with ongoing use

     
     
    Lidocaine Injection
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    Formulary
    Amber

    Injection - various strengths.



    • DCHFT: 0.5%, 1% and 2% available.


    Primary Care: for use in minor surgery and soft tissue injections

     
     
    Lidocaine with Adrenaline Injection
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    Formulary
    Amber

    • DCHFT: Lidocaine 1% and 2% with adrenaline (various strengths). Dental cartridges.


    Primary Care: for use in minor surgery and soft tissue injections

     
     
    Lidocaine 700mg plasters (5%)
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    Formulary
    Red

    Only within licensed indication (post herpetic neuralgia) by pain specialists. It remains non-formulary for other indications apart from restrictions listed below


     


    Restricted Item Additional Acute Trust restricted indications (off-label):
    RBCH:



    • Rib Fracture Pain: - Max 5 days supply

    • Post-amputation pain: Acute Pain Consultant only:where other analgesics or anaesthetic techniques are contra-indicated or have limited benefit - Maximum 30 days supply. Patients must be informed that this treatment is short-term before commencing therapy.


    DCH: Rib Fracture Pain: - Max 5 days supply. Patients must be informed that this treatment is short-term before commencing therapy.

    PHT: Rib Fracture Pain

     
     
    Lidocaine 10% spray  (Xylocaine®)
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    Formulary
    Red

     


     

     
     
    Lidocaine 40mg/ml solution (Laryngojet®)
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    Formulary
    Red
     
     
    Lidocaine 5% and Phenylephrine 0.5%
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    Formulary
    Red
    Pump spray. 
     
    15.02  Expand sub section  Mepivacaine
    Mepivacaine (Scandonest Plain®)
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    Formulary
    Red
    Injection. 
     
    15.02  Expand sub section  Prilocaine
    Prilocaine Hydrochloride (Citanest®)
    (1%)
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    Formulary
    Red
    Injection. 
     
    Prilocaine Hydrochloride (Prilotekal®)
    (2% Hyperbaric)
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    Formulary
    Red
    Injection.
  • Restricted Item  DCHFT: Day case and enhanced recovery patients only in accordance with local guideline.

    RBCH for short procedures in patients suitable for same day surgery by Consultant Anaesthetists only. 
  • Link  DCHFT: Guidelines for use of “Prilotekal” hyperbaric 2% prilocaine for use in spianl anaesthesia.
     
    Prilocaine Hydrochloride with Felypressin (Citanest with Octapressin®)
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    Formulary
    Red
    Dental cartridge. 
     
    Prilocaine Hydrochloride
    (0.5%)
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    Unlicensed Drug Unlicensed
    Red
    Injection.
  • 0.5% is unlicensedunlicensed.
  •  
     
    15.02  Expand sub section  Procaine
    15.02  Expand sub section  Ropivacaine
    Ropivacaine Hydrochloride (Naropin®)
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    Formulary
    Red
    Injection, infusion.
  • DCHFT: Non-formulary item.
  •  
     
    15.02  Expand sub section  Tetracaine to top
    Tetracaine (Amethocaine) (Ametop®)
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    Formulary
    Green
    Topical gel. 
     
    15.02  Expand sub section  Other local anaesthetics
    Controlled Drug Cocaine
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    Formulary
    Red
  • DCHFT Only: 10% sterile nasal solution. unlicensedUnlicensed.
  •  
     
    Ethyl Chloride (Cryogesic® Spray)
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    Formulary
    Red
    Aerosol spray. 
     
     ....
     Non Formulary Items
    Articaine Hydrochloride with Adrenaline  (Septanest®)

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    Non Formulary
    Benzocaine

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    Non Formulary

     


     

    Benzocaine 20% Gel  (Ultracare® Bubble Gum)

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    Non Formulary
    Controlled Drug  Bupivacaine with Fentanyl

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    Non Formulary
    Controlled Drug  Cocaine with Adrenaline

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    Non Formulary
    Dermogesic spray

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    Non Formulary
    Lidocaine with Adrenaline  (Xylocaine®)

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    Non Formulary
  • Lidocaine 1% with adrenaline 1 in 200 000

  • Lidocaine 2% with adrenaline 1 in 200 000

  • Lidocaine with tetracaine  (Pliaglis®)

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    Non Formulary
    Procaine Hydrochloride

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    Non Formulary
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Green

    May be initiated, stabilised and maintained in primary, secondary or tertiary care  

    Amber

    Amber drug - without shared care  

    Amber SCG

    Amber drug - with shared care guideline  

    Red

    For secondary or tertiary care initiation and long-term maintenance of prescribing  

    Black

    Not recommended  

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