The following AAOMS Advisory is a result of an investigation initiated by FSOMS member Dr. Stephen Kotkis, a sedation/general anesthesia inspector for the Florida Department of Health, Division of Medical Quality Assurance. The lidocaine mentioned in the advisory was found on inspection in place of “LIDOCAINE FOR CARDIAC USE” which many have been unable to obtain, being told it was back ordered due to a manufacturing shortage. The company’s response that their product insert does not include cardiac use led the company to respond that use for cardiac arrhythmia is an off label use. That response was forwarded to the Chairman of the AAOMS Committee on Anesthesia with the resulting advisory.
AAOMS members should be aware that a specific lidocaine product is not intended for cardiac use and is not labeled “For Cardiac Use,” according to the manufacturer. The drug is: Lidocaine Hydrochloride Injection USP, 2% (20 mg/mL), supplied by Aurobindo Pharma USA.
Using this preparation of lidocaine for a cardiac arrhythmia in an emergency would be considered off-label use and could place an oral and maxillofacial surgeon at medico-legal risk.
American Association of Oral and Maxillofacial Surgeons
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