Infants requiring painful bedside surgical procedures (suturing, circumcision, thoracostomy tube placement, etc.) should receive local anesthesia if possible. Xylocaine may be chosen as a local anesthetic. Single use Xylocaine is kept as part of the Rx replacement drug standard in the NICU.

Xylocaine should be drawn up using a filter needle from the ampule and administered by the physician performing the procedure.

1% Xylocaine may be used for infants > 1200g.

Infants < 1200g should receive 0.5% Xylocaine prepared by using 1% Xylocaine and normal saline in a 1:1 dilution.

See also NICU Nursing Guidelines 40:08.25.