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In general lidocaine should not be given to patients with hypovolaemia, heart block or other condition disturbances, and should be used in with caution in patients with congestive heart failure, bradycardia, or respiratory depression. Lidocaine is metabolised in the liver and must be given with caution to patients with hepatic impairment or pseudocholinesterase deficiency. Metabolites of lidocaine may accumulate in patients with renal impairment. May have increased risk of lidocaine toxicity.
The intramuscular injection of lidocaine may increase creatine phosphokinase concentrations that can interfere with the diagnosis of acute myocardial infarction.
