See here for videos for suturing and local anaesthetic infiltration.
Local anaesthetic (LA) maximum doses: Lignocaine 1% 0.3ml/kg (3mg/kg)
It is important that you calculate the maximum dose of local anaesthetic agent you can use prior to injecting and use slightly less than this.
If a patient advises that the LA has failed it is likely to be for one of the following reasons; insufficient time given for the onset of anaesthesia/ anaesthetic effect was allowed to wear off before procedure started/ Incorrect site of injection.
Complications of local anaesthetics:
Acute Systemic Toxicity (rare) Most commonly caused by accidental intravascular injection Can occur as a result of rapid systemic absorption.
Signs of Toxicity are as follows:
numbness of tongue and mouth, signs of CNS stimulation due to depression of inhibitory centres light headedness, tinnitus, visual disturbance, slurred speech progresses through muscular twitching, confusion, convulsions, coma, apnoea hypertension and tachycardia and ventricular arrhythmias.