Formulary


	NHS Bath and North East Somerset, Swindon and Wiltshire CCG Royal United Hospitals Bath NHS Foundation Trust Great Western Hospitals NHS Foundation Trust Salisbury NHS Foundation Trust

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Formulary Chapter 15: Anaesthesia - Full Chapter

15.02

Local anaesthesia

15.02

Bupivacaine

Bupivacaine and Adrenaline
(injection)

Formulary

0.25% w/v
0.5% w/v
1 in 200,000

Bupivacaine Hydrochloride
(injection)

Formulary

25mg in 10ml (0.25%) amp
50mg in 10ml (0.5%) amp
75mg in 10ml (0.75%) amp
GWH only: 0.1% and 0.125% epidural infusion bags used.

Bupivacaine Hydrochloride with Glucose
(injection)

Formulary

0.5% solution for injection, 4ml ampoule
Not routinely stocked at RUH

15.02

Levobupivacaine

Levobupivacaine
(injection)

Formulary

25mg in 10ml (0.25%) amp
50mg in 10ml (0.5%) amp

Levobupivacaine with Fentanyl
(IV)

Formulary

GWH only.
Epidural

15.02

Lidocaine

Lidocaine (Xylocaine)
(Spray 10%)

Formulary

SFT only
This product is non-sterile and therefore not recommended for use prior to procedures that require aseptic techniques
Lidocaine 10 mg/metered dose.
Used for the prevention of pain related to specific procedures
Contains ethanol
50 ml glass spray bottles (approx. 500 spray doses) with a metering spray pump.

Lidocaine 2.5% with Prilocaine 2.5%
(EMLA^®)
(cream)

Formulary

Lidocaine 2.5%, Priolocaine 2.5%, 30g, 5g with dressings

Lidocaine 5% and Phenylephrine 0.5%
(spray)

Formulary

Each bottle contains 2.5ml of solution to be used as a spray, equivalent to 125mg lidocaine and 12.5mg phenylephrine hydrochloride.

Lidocaine Hydrochloride (injection)

Formulary

50mg in 10ml (0.5%) vial
20mg in 2ml (1%) amp
50mg in 5ml (1%) amp
200mg in 20ml (1%) amp
200mg in 20ml (1%) vial preserved
100mg in 5ml (2%) amp
100mg in 5ml (2%) prefilled syringe
400mg in 20ml (2%) amp

Lidocaine with Adrenaline
(injection)

Formulary

Xylocaine 1% with adrenaline 1:200,000 multi-dose vial, 20ml and xylocaine 2% with adrenaline 1:200,000 multidose vial, 20ml.
for use in acute trusts
for use by GPs in primary care undertaking minor procedures/surgery
for GWH only: Lidocaine dental cartridges -Lignospan Special® (Lidocaine hydrochloride 2% + adrenaline 1:80000).

Lidocaine2% with Chlorhexidine 0.25%
(Instillagel^®)

Formulary

Lidocaine 20mg/ml and chlorhexidine gluconate 500mcg/ml. 60ml or 110ml

15.02

Prilocaine

Prilocaine Hydrochloride
(injection)

Formulary

Spinal anaesthesia 20mg/ml for injection, 5ml ampoule

Prilocaine Hydrochloride with Felypressin
(injection)

Formulary

54mg (3%) with felypressin 0.03 units/ml 1.8ml cartridges

Prilocaine (+ glucose)
(Prilotekal®)
(IV)

Formulary

GWH only
Due to the glucose content Prilotekal is only to be used for spinal anaesthesia. It is not recommended for the use in epidural anaesthesia.

15.02

Tetracaine

Tetracaine (Amethocaine)
(Ametop^®)
(gel)

Formulary

Gel 4% 1.5g

15.02

Other local anaesthetics

Articaine Hydrochloride with Adrenaline
(injection)

Formulary

Articaine hydrochloride 40mg/ml, adrenaline 1 in 100,000 (10 micrograms/ml), 2.2ml cartridge for dental use

Cocaine HCl
(Solution 10% w/v)

Formulary

GWH only
Sterile oromucosal solution 10%
For topical use only. Not for injection or to be taken.
Cocaine Hydrochloride Solution is indicated to provide local anaesthesia and vasoconstriction of accessible mucous membranes prior to surgery especially in the oral, laryngeal, and nasal cavities.

Ethyl Chloride
(Spray)

Formulary

100ml
CAUTION: Extremely flammable liquified gas under pressure. Stable at room temperature 8ºC-20ºC. Use only with good ventilation. Avoid use near electrical equipment, naked flames or high temperature surfaces. Store in a metal cupboard in a ventilated room- never in a refridgerator. All empty or unused containers must be returned to pharmacy for destruction.

Ropivacaine hydrochloride
(Injection)

Formulary

SFT only
2mg/ml, 7.5mg/ml or 10mg/ml

Cocaine 5% with adrenaline 1:2000
(Topical gel)

Unlicensed

GWH A&E only

....

Non Formulary Items

Benzocaine

Non Formulary

Benzocaine 20% Gel
(Ultracare^® Bubble Gum)

Non Formulary

Bupivacaine with Fentanyl

Non Formulary

Dermogesic spray

Non Formulary

Lidocaine
(laryngojet^®)

Non Formulary

Lidocaine 4% cream
(LMX4^®)

Non Formulary

Lidocaine with Adrenaline
(Lignospan^®)

Non Formulary

Lidocaine with Prilocaine
(Fortacin^®)

Non Formulary

Lidocaine with tetracaine
(Pliaglis^®)

Non Formulary

Lignocaine

Non Formulary

Mepivacaine
(Scandonest Plain^®)

Non Formulary

Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG
	High Cost Drug Approval System

Traffic Light Status Information

Status	Description
	RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.
	Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.
	Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.
	These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.
	Suitable for patient to be directed to buy themselves
	Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.
	(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.
	Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.