Not to be used as IA continuous infusion. Impaired CV function; 2nd- or 3rd-degree AV block; severe or untreated HTN, thyrotoxicosis, ischemic heart disease, cerebrovascular insufficiency, advanced diabetes & other adrenaline-exacerbated conditions; use in peripheral body parts eg, fingers or body parts having low blood supply. May cause allergic reactions due to Na metabisulphite. Insert IV cannula before local anaesth. Retro- & peribulbar inj, paracervical block. Epidural anaesth can lead to hypotension & bradycardia; reduce risk of such effects by eg, vasopressor inj. Inadvertent intravascular administration. High-dose use. Concomitant use w/ class III antiarrhythmics. May affect ability to drive & use machines. Severe hepatic or renal impairment. Pregnancy & lactation. Elderly.