All Content on This Web Site Copyright 2010-2014

John Rourke - ModernSurvivalOnline.com

Join the ModernSurvivalOnline Insider's Email List 

We respect your email privacy

My Twitter Feed……

DoomandBloom.net

medical preparedness and first aid

Site Archives

Click here for more info.
Click here for more info.

Emergency Essentials

survival & preparedness supplies

Forge Survival Supply

tested survival & preparedness supplies

4 Foot Gardening

4 foot gardening blueprint

RangerUp.com


Sheepdog
Prepping Blogs
Condition Factor Monitoring

Vote for MSO!!

Click here for more info.

Guest Post: How to make injectable Lidocaine HCL

How to make injectable Lidocaine HCL

by RalphP

 

Almost every other prepper / survivalist that I’ve met shares a similar “hope for the best, but prepare for the worst” philosophy about life.  If this pretty much describes you too, than you’ve probably considered a SHTF situation where, with no access to doctors or dentists, you might be forced to perform some type of minor surgery at home.  Draining an abscess or pulling a tooth maybe.  These are common minor surgeries, but with no anesthesia (or only over-the-counter varieties) they might be very painful.  You’ve probably also thought about how you might treat trauma, like lacerations, punctures, or burns – where suturing, debriding, or removing foreign objects from a wound might be necessary.  Painful enough for an adult, but worse for a child to have to endure.  And while no sane person really wants to think about the worst cases, like having to treat a gunshot, knife, or chainsaw injury to a loved one, you know that ignoring the possibility doesn’t make it any less likely to happen either.  Hope for the best, but prepare for the worst.  TEOTWAWKI might be a dangerous place to live.

 

Everyone also agrees on the need for First-Aid training and supplies; but in cases of more severe trauma, First-Aid is just that – the “first aid” provided to the victim to limit further harm while getting them to a hospital for professional care.  If the SHTF than the “hospital” is most likely going to be your home, and it’s there that the bandage will need to be removed, the damage accessed, and a decision made on how best to promote healing.  This may require invasive, and painful, examination and treatment.  Some might be able to ‘bite the bullet’, but others, particularly children and certainly animals, couldn’t.  Recoiling from pain is an involuntary response and one of the most primitive instincts.  The lack of an effective local anesthetic would not only limit what medical procedures could reasonably be performed, but also result in unnecessary pain in those that could be.  Now fantasies about an untrained medic performing vascular surgery, nerve or tendon repair, or a bowel resection aside – it is a fact that for some injuries the penalty for surgical failure isn’t going to be any worse than if you do nothing at all, so you may want to try.  Local anesthesia will be needed to help the patient to remain still, or if nothing else than to help ease their pain.

 

What you’ll need:

 

Lidocaine Hydrochloride (HCL) powder (roughly $1 per gram in small quantities)

Sterile saline, or distilled water (varies, $10 for 24 of the single-use saline vials I chose)

Thermometer, accurate up to 200 degrees F or so ($10 and up)

Scale, accurate down to 1mg or less. ($25 and up)

Funnel, small

Surgical clamp

Scissors

A clean work area with a stove or other way to heat water

 

Lidocaine Hydrochloride (HCL) powder is available in lab grades from online distributors if you can’t obtain it in USP grade.  You want “Lidocaine HCL” which is water soluble, not the straight “Lidocaine powder” or “Lidocaine base” which isn’t.  It should be stored at room temperature according to its Material Safety Data Sheet, and has no predetermined shelf life or expiration date if stored in an airtight container – or at least none that I’ve been able to determine anyway. (see note 1)

 

The supplies and materials I used:

 

My beautiful picture

 

The isopropyl alcohol shown above isn’t part of the solution, it’s used for cleaning the equipment.  Before you begin, all the equipment and anything they might touch, including you, should be thoroughly cleaned with a disinfectant or antiseptic.  Boil any items that can be.  Scrub and glove your hands.

 

For the sterile saline, I chose a type packaged in 15ml plastic vials and marketed for nasal irrigation purposes.  Search on “ModuDose” and you’ll find it (see note 2).  Mine were dated as expiring in one year, I plan to use them beyond that date unless they turn cloudy or have particulates in them.  I like this particular kind as they’re the perfect size for creating single doses with minimal waste, and they lessen the chance of contamination by not having to mix and transfer the solution between multiple containers during the process.

 

My beautiful picture

 

To produce a 2% lidocaine HCL solution (weight/volume), weigh out 0.3 grams (300mg) of lidocaine HCL, snip the top of the 15ml saline vial about half way down the neck with scissors, insert the funnel securely into the neck of the vial, and pour the lidocaine HCL powder into the funnel.  The powder tends to stick to the funnel, so you’ll probably need to gently squeeze the vial to force the saline up into the funnel, then release to allow the saline to flow back down into the vial carrying the lidocaine HCL powder with it.  Repeat as necessary to get all the lidocaine into the vial. Remove the funnel, and seal the neck of the saline/lidocaine vial using a surgical clamp or needle holder.

 

With the 2% lidocaine/saline solution vial now sealed shut, place the vial into a small pan of normal tap water, being careful not to submerge it fully – we don’t want any tap water to enter the vial.  Heat the water past 176 degrees Fahrenheit (I found it easiest to place a small glass filled with tap water into the pan the water, like a double boiler) and allow it to remain slightly above that temperature for 2-3 minutes.  Lidocaine HCL melts at 176 degrees F (80C), and dissolves in water.  Allowing the lidocaine HCL to melt, not just dissolve, in the saline ensures even distribution with no chance of particulates.  If particulates do remain at this point, they’re not lidocaine HCL and the solution shouldn’t be used.

 

My beautiful picture

 

Remove the vial from the pan, and keeping it securely clamped closed, allow it to cool.  You now have 15ml of 2% lidocaine HCL ready for use, which is also about the maximum recommended safe dosage for an adult.

 

My beautiful picture

 

Use it the same as you would any other vial of Rx injectable solution:  With the vial still clamped shut, clean a section near the top of the vial with an alcohol pad, invert the vial, insert the needle through the plastic section just cleaned, and draw out the desired amount into the syringe.

 

For different amounts of solution, or to make it in different concentrations, the formula is:

[Weight of lidocaine in grams  /  Volume of saline in milliliters] x 100.  For example, 1 gram lidocaine / 100 milliliters of saline = .01 X 100 = 1% solution.

 

As my first real test, I used a 0.5ml insulin syringe with a 30G needle, and performed three injections for a total of 1.5ml of 2% lidocaine in a 1″ square area just above the knee.  In a real situation a 6-10ml syringe with a longer needle would probably be better, I just have a lot of insulin needles stored so I used them instead.  Surprisingly, there was no sting from the lidocaine solution over that of the saline alone (tested first as the control).  I had expected some mild stinging, as is normally reported with Rx lidocaine without any sodium bicarbonate solution added, but there was no noticable difference.

 

My beautiful picture

 

Anesthetic effect was good and as expected.  In other words, the area injected and the immediate vicinity around it was completely numb.  Hospital / Clinic / Prescription Strength numb.  It reached full effect in about 10 minutes, and lasted a little over 30 minutes total before wearing off rather quickly.  The lack of epinephrine and, I suspect, the lower viscosity of the saline used here than in the lidocaine solution available by Rx probably allows it to disperse, and wear off, faster.  In further testing, I’ve used up to 6ml of 2% lidocaine in a single application, and even had some success at performing digital (fairly easy) and radial (not so much) nerve blocks.

 

In closing, I think it’s safe to assume that the solution should be used within 24 hours and any leftover discarded since it doesn’t contain any preservatives or antibacterials.  With practice and the materials handy it only takes about 20 minutes to make more.  I created a small kit with all the supplies, including pre-weighed lidocaine packets in tiny zip-loc bags that are clearly marked, in case I need to make it in a hurry.  Hope no one ever needs to.

 

Notes:

(1) Most sources of Lidocaine HCL that I found listed it as “Reagent ACS” grade, which is not for any medical use.  But that grade does require certification by the American Chemical Society, who tests batches from a production run and provides a Certificate of Analysis (COA) to the manufacturer as part of their certification.  A description of the different chemical grades is available here: http://www.reagents.com/products/reagents/grades.html.  Many sellers will provide this COA on request, but who can say what contamination may have occurred while the seller was repackaging the product into smaller quantities for retail sale?  Or even that the COA is from the same batch they sold you?   If that concerns you then it might help to consider that  thousands, if not millions, of people are snorting this same Reagent ACS grade lidocaine daily, as it’s a common dilutant added to street cocaine.  It’s also a fair question to ask if lab grade chemicals today are less pure than medical grade chemicals used 50-100 years ago.  But then again, what if your seller confused your lidocaine order with someone else’s strychnine order (both being white crystalline powders)?   Just trying to give both sides as I see them – and make a plea that you choose carefully and test cautiously if you decide to try this.  One bit of good news is that you’ll probably only ever need to test a single batch, since one $50 order would be a lifetime supply.

 

(2) Most OTC sterile saline solutions are labeled “not for injection”, which I believe indicates they haven’t been tested as being pyrogen free, and which is one requirement to be USP certified “for injection” purposes.  More on pyrogens here: http://www.fda.gov/iceci/inspections/inspectionguides/inspectiontechnicalguides/ucm072906.htm   There might be other factors I missed that separates “for injection” versus “not for injection” sterile saline.  For infrequent use and in the amount discussed here, the risk seems minimal.   I’d think that factory sealed “not for injection” sterile saline is still a safer option than using distilled water, but I’m not a doctor.

 

**************************************************************

The article above was an entry into the ModernSurvivalOnline Preparedness Guest Post Writing Contest.

Have something to share? You could win one of the following prizes.

First Place winner will receive:

Second Place will receive:

Third Place will receive:

 

 

28 comments to Guest Post: How to make injectable Lidocaine HCL

  • Finally my long search for a legal anesthetic has yielded fruit. What a cool guest post, thank you. That’s some good advanced Prepper stuff right there.

  • Thomas T. Tinker

    Rourke olde fella…. Among all the posts I’ve read in here for… at least the last two years… this one has given me the greatest gem of information do date. 2%Lido/HCL is a true gift sir.

  • D.

    One very big note of WARNING:
    If accidentally injected into a blood vessel, Lidocaine causes cardiac arrythmias and seizure.

    Other wise I liked the article, very useful information. Those studying WROL anethestia might also look into food grade Nitrous Oxide. Again, a WARNING: NO2 displaces Oxygen, so it should be administered with the NO2 to avoid anoxia.
    Please carefully study any planned WROL meds. Remember the Physicians mantra “Do no harm”
    Regards, D.

  • Suni

    GREAT Information. Thank YOU guest writer. Have been looking for this type a long time. Thank you, Thank you, Thank you!!!

  • John W Manuel

    This has been one of the craziest, most useful posts I’ve seen. I’m in the medical field and I figure in a SHTF scenario, I will be a medic of sorts so I especially like the post.

  • James

    Great, useful, practical post. Thank you!!!

  • Ralph

    Thanks for the kind words all, hoped it’d be useful info. I’d been looking for non-Rx / shelf stable lidocaine since pre-Y2k, stumbled on the powdered lidocaine HCL almost by accident late last year and started reseraching how we could use it.

    At one point in the write-up there was about 50 warnings/disclaimers, but it made it almost unreadable so I moved the ones I thought the most important to the notes at the bottom. I left out most everything about how to administer it because it got too broad a topic, and I’m not trained to do it anyway. I hope no one would start injecting themselves with a recipe off the internet without doing their own homework anyway. I’m not ashamed to say that I was pretty scared during the first full-strength (2%) test, but now after about 14 batches/trials (and no side effects) it’s routine. A willing survivalist cousin volunteered as a guinea pig for my test in someone besides me, and gave me my first opportunity to put a suture in human skin too.

    http://www.hostpic.org/images/1303132352440100.jpg (fuzzy.. cheap cam. That’s a #1 suture, not 1-0. Big cutting needle! It’d hold a leg on :) )
    http://www.hostpic.org/images/1303132353460098.jpg (the supplies, and mess, for one suture. Store lots of med supplies, you’ll need them.)

  • GoneWithTheWind

    Call me chicken but I would rather have the pain. I’m not going to inject any home made stuff. I do have a question. Is this legal?

  • Jason H

    Wow, what a great post. If anyone can answer this – is this the same or similar to Benzocaine powder?

  • ralph

    couple of points.

    1) to D. – lidocaine used to treat ventricular arrhythmias in the past, been replaced by newer drugs .yes, large doses can cause cardiac asystole, and can lead to seizures as well. keep to 3miligrams per kilogram bodyweight.

    2) to JasonH- no they are not the same.

    3) to All- dont use this for anything except local infiltration. no nerve blocks, spinals, etc. period. you need the
    real deal without any chance of contamination. check out MedCallAssist.com. for a fee, and a proper medical history workup, they will provide a comprehensive first aid kit, with drugs, and you can add lidocaine to it if you wish. they are the real deal. and provide 24 hour telemedicine backup for 1 year. cost approx 250-275$. learned of the this from survivalmom.com.

  • Johnny

    May want to run it through a disposeable .2 micron disc filter, just to help with particulates and any bacterial contamination. The filters are cheap on eBay.

  • Ralph

    GoneWithTheWind: I don’t know, I’m not a lawyer either ;)

    Jason H: Benzocaine has a higher melting point, but still less than the boiling point of the saline so you could get it hot enough to melt. I think the problem might be that benzocaine isn’t as soluble in water, so after the solution cooled it might separate from the saline. Like oil in water maybe, but I’m not sure.

    ralph: I’m with you on the spinal, but no peripheral nerve blocks? We went much deeper for the suture below the thumb test than I had to go to achieve a digital nerve block. Would like to understand your concern here.

    Johnny: That’s a good idea, thanks.

  • God-fearing Canadian

    I have bought both Lidocaine HCL (50g) and Epinephrine (Epipens) off of E-bay, and later got prescribed more Epinephrine to use for my SHTF purposes. If too much of the concoction is administered to the subject, respiratory depression may ensue, just like an overdose on opiates. Just in case this happens, I have acquired Naloxone HCL in glass vials (0.4 mg/L) that can be injected to counteract the overdose. You can never be too careful. Naloxone HCL is commonly administered in hospitals and every nurse knows of it and may be able to help you acquire some. I am not a medical expert but I do have a strong scientific background. I cannot overemphasize the dangers involved in using Lidocaine HCL on a test subject. Buy an older version (2009-2010) of Pearson’s Health Professional’s Drug Guide online for $0.50 and then you will actually know what you are doing when administering these drugs. This is not as simple as it seems and you need to know what to do in the 1% of cases when all hell breaks loose following administration of the Lidocaine. Yes, we are all trying to do our best but we can do better. Buy the book just in case the internet goes down and you have no reference. This book will also help when 90% of the population dies off and you raid your neighbour’s medicine cabinet.

  • Kanga

    As a retired Law Enforcement officer I can tell you it IS NOT legal in California or Oregon it falls under Manufacturing Controlled Substances. It would be the same as far as the law is concerned as a home lab manufacturing meth. In a SHTF scenario, who cares about the law right… WRONG!

    I will still use the old fashioned leather wrapped biting stick and have several people holding me down. NO way, would I inject any home brew into my body or any of those I care for. Thumbs Down… sorry

    Kanga

  • Ralph

    Officer Kanga, lidocaine is not a controlled substance, neither in California nor any other state I’m aware of. If it were it would only be available by Rx, or not at all in the case of drugs like meth. In any event, this isn’t a recipe for manufacturing anything. This is pharmaceutical compounding of completely legal ingredients – NaCl in sterile water, and lidocaine hcl.

    http://www.leginfo.ca.gov/cgi-bin/displaycode?section=hsc&group=11001-12000&file=11053-11058

    As the law is your professed specialty and not medicine, I believe your other points are moot as well. Sorry.

  • Kanga

    I would have to disagree with Ralph.

    lidocaine hydrochloride is a C-III controlled substance, which means that it has potencial for drug abuse but is medically accepted.

    I worked narcotics cases for over 17 yrs. and am well aware of the illegality of manufacturing controlled substances. I can also prove the fact that Lidocaine Hydrocloride IS a controlled substance. Please review the U.S. Dept. of Justice web site

    http://www.deadiversion.usdoj.gov/fed_regs/rules/2006/fr08292.htm

    If you were to really research the point, any altering, packaging, combining, compounding or distilling of any controlled substance “IS manufacturing” and charged as such. I’m not about to debate the issue, just try to buy it over the counter from your local pharmacy. They will inform you that you that you need a Rx before they can sell it to you. Yes, it is true that you could buy many “precursor chemicals” thru the internet. (That kept me working for years). At the time you change this schedule 3 controlled substance from its original manufactured form it is the crime of ” Maunfacturing”. Schedule 3, is punishable for up to 5 yrs.

    It’s true not everyone likes old cops,, but I held this career and made many many prosecutable arrests thru thousands of narcotics investigations.

    GOOD LUCK,,, Nuff said!

  • Rourke

    Kanga –

    Appreciate the information.

    Rourke

  • Ralph

    Officer Kanga, did you even bother to read your link, or just google for “scheduled drugs” and “lidocaine” and then post it?

    Your link is for the drug Embutramide, a sedative, and it’s placement on the list of Schedule III drugs. Just reading the title confirms that. The mention of lidocaine is in regard to it being one ingredient in “Tributame Euthanasia Solution”, which is a scheduled drug because it contains Embutramide.

    Lidocaine is not a scheduled drug, and even if it were this is not instructions on manufacturing it. The instructions here
    are for combining legal ingredients, all unscheduled and available without prescription. The chemical structure of the final solution is not changed, it’s lidocaine hcl diluted in saline. No new chemical is manufactured or formed by the process. The procedures here are no more illegal than adding powdered cold remedies to a cup of hot tea, or dropping an Alka-Seltzer in a glass of water.

    Rourke, and all, I highly recommend you read Officer Kanga’s link and decide for yourself.

  • Ralph

    In case there is any lingering doubt that Officer Kanga might be correct in his belief that lidocaine is a controlled substance, the links to the complete list of all scheduled drugs is available here: http://en.wikipedia.org/wiki/Controlled_Substances_Act

  • Kanga

    If you like Wiki, here it is very simple:
    http://wiki.answers.com/Q/Is_Lidocaine_a_controlled_substance

    If you like law, here it is very simple:

    UNIFORM CONTROLLED SUBSTANCES ACT

    475.005 Definitions for ORS 475.005 to 475.285 and 475.752 to 475.980.

    (9) “Device” means instruments, apparatus or contrivances, including their components, parts or accessories, intended:

    (a) For use in the diagnosis, cure, mitigation, treatment or prevention of disease in humans or animals; or

    (b) To affect the structure of any function of the body of humans or animals.

    (15) “Manufacture” means the production, preparation, propagation, compounding, conversion or processing of a controlled substance, either directly or indirectly by extraction from substances of natural origin, or independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis, and includes any packaging or repackaging of the substance or labeling or relabeling of its container.

    My best suggestion remains unchanged! Don’t do it!

    BTW — I’m just Kanga now, the Officer is retired.

  • Ralph

    wiki.answers.com says it’s a scheduled drug? But that’s not what chacha.com says…

    Your entire “controlled substance” argument rests on whether or not lidocaine actually IS a controlled substance. So just produce the law or regulation that proves lidocaine is a controlled substance under state or federal law, and you’ll be right. Should be easy for a retired narcotics officer.

  • ralph

    to Ralph- my concern is to the actual sterility and lack of contaminants in the solution, and injecting in and around a nerve plexus. having an infection start in such an area would definitely not be good. could lead to irreparable nerve damage. that was my concern. performing a digital block, as you described, could lead to same issues. if you are desperate, well you can take your chances i suppose. adding a micro particulate filter may help, but any contaminants in solution at a molecular level are not going to be removed. having had the drug actually processed under aseptic conditions is a must in my estimation. bacteria are not the only concern, there are spores, fungi and viruses that are everywhere, and those can only be inactivated by high temperature achieved under pressure in an autoclave. i believe the temperature must be 121 degrees centigrade, for 15 minutes. also, most drugs are manufactured using laminar flow environments to reduce contamination.

    Kanga- lidocaine is not a controlled substance. ie a narcotic. it may be against the law to obtain without a prescription, but that is a different matter altogether. lidocaine is never locked up with the narcotics. nor is it counted, and the wastage never has to be cosigned with anyone. as to your comment ” In a SHTF scenario, who cares about the law right… WRONG!” , the law in that situation will likely not be around anyway. the whole idea of outlawing drugs is ridiculous, and a waste of time, energy, and resources. by keeping “drugs” illegal, you sustain a profit motive for the dealer, you create a whole industry of law enforcement, prison system, and more than likely, there is continual bribing of officials across the spectrum. we have had a war on drugs for 40 years to what end? more police, prisons, still more drugs available and for what??? all for victimless crime of self indulgence by some fringe of society. yes, some people die, or are traumatized, mostly over the monetary issues, or by moronic, out of control user. they require psychiatric intervention, not incarceration. i will step off the soapbox now.

  • Ralph

    ralph – I’m finding your points hard to argue, since it’s a given the environment isn’t sterile and the type of contaminants, if any, are an unknown. Infection as a result of the lidocaine injection seems less of a concern than from that of the wound itself. But I’d concede that infection aside, a contaminant in the mixture itself could even be neurotoxic. It’s an unknown. Lidocaine itself is neurotoxic in higher concentrations.

    There was a recent recall of Rx drugs from a compounding pharmacy linked to a fungal meningitis outbreak, and their inj. lidocaine was one of the products recalled. Just mentioning this lest anyone believe Rx drugs are always safe, contamination is a frequent cause of Rx recalls.

    The only evidence I can point to, anecdotally, is lidocaine’s frequent use in the illegal drug market. While nerve damage in the nasal passages and lungs is often a result of chronic cocaine use. I’m not able to find where it ever occurred after a single use, or that even in chronic users that the damage was attributed to the lidocaine dilutent and not the cocaine itself. A poor argument, but the best I have. Thanks for your reasoned comments. All aspects of this need exploring.

  • ralph

    Ralph, as i said before at the onset of the discussion, check out MedCallAssist.com.i purchased one of their kits, and added lidocaine to the mix, and the appropriate syringes and needles also. all their goods are name brand, quality products. make the other lidocaine only as a last resort. good info, nonetheless. oh, one last thought, i remember from my college days inhaling nitrous oxide from rediwhip cans, and if you hold your breath, you can become quite detached from normal awareness, say 10-15 seconds, then you breath the atmosphere once again, and your normal brain function returns. could use that short interval for some short, painful procedure, ie setting a fracture etc.
    just dont tip or shake the can, or all you will get is a mouthful of whip cream, lol.

  • Being on this planet for sixty years, I am also a Viet-Nam vet and I can honestly say I have been sewn up on a few different occasions. I would much rather be numbed a little with a gaping wound than not at all. If the SHTF scenario ever does happen, any kind of medical attention would be most welcomed if needed. Legal or not!

  • Bob

    I spent nearly 20 years in law enforcement, even serving two terms as an elected Sheriff. I do not believe that Lidocaine as described here (Lidocaine Hydrochloride HCL powder) is illegal, and couldn’t find it listed in the orangebook of scheduled drugs.

    http://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf

    You can also buy it online, http://www.lidocainepowder.com/, which further seems to indicate that its not illegal (DEA would shut them down I’m quite sure if it were illegal to sell / possess). I can’t directly say you aren’t correct in your state Kanga, but I think the point at which it would become illegal is if someone were to take DEA approved and labelled, medically intended, injectable Lidocaine (say from a dentists office) and then turn around and sell it privately.

    In the end, whether the act is legal or illegal its only meant for a post law and order world. I think this article was an awesome choice for winning guest post and while I won’t be running out to make/test this out, it’s something I’ll print and store in my bag of life essential information. The point behind this type of information isn’t to break the law or prove we don’t need modern medicine, but to help people survive if the unthinkable ever happens.

    I’m like Mark Owen… if something ever happens and I need cutting or stitching, I’ll be praying like heck that RalphP is around with some of his homemade numbmyass.

    Disclaimer: I’m not a lawyer and I could be wrong (so my wife says), this is my opinion only.

  • [...] not advocating for this, but I just ran across it the other day: How to make injectable lidocaine: http://modernsurvivalonline.com/gues…lidocaine-hcl/ I haven't even read the whole article myself, so this comes with a disclaimer, just thought it [...]