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Overview

Xylocaine 4% Injection

Manufacturer: Astra Zeneca
Medicine composition: Lidocaine
Prescription vs.OTC: Prescription by Doctor not required

Xylocaine 4% Injection is a local anesthetic. It is used topically on the skin to reduce itchiness and skin conditions such as insect bites, eczema and burns. It is also used to cure hemorrhoids and problems of the genital/anal regions. This medication functions by reducing pain, redness and swelling. The viscous variant is used for dental treatment.

On using Xylocaine 4% Injection you may experience certain side effects such as a burning or stinging sensation, dizziness, drowsiness, changing body temperatures, blurred vision or a pounding/ringing in your ears. Severe reactions include depression, numbness and vomiting. Should your reactions continue and become worse over time contact your doctor right away.

Before using Xylocaine 4% Injection inform your doctor if: you are allergic to any medicine, food, substances or ingredients contained within Xylocaine 4% Injection, you have diabetes, liver/ stomach problems and infections.

Take the dosage recommended by your doctor for your condition. This topical medication comes as a gel, spray, cream, lotion and skin patch. Apply on the affected area of the skin after cleaning and drying it well. It is usually recommended to use about 2-3 times a day.

Information given here is based on the salt and content of the medicine. Effect and uses of medicine may vary from person to person. It is advicable to consult a Anesthesiologist before using this medicine.

piles
, local anaesthesia and
In addition to its intended effect, Xylocaine 4% Injection may cause some unwanted effects too. In such cases, you must seek medical attention immediately. This is not an exhaustive list of side effects. Please inform your doctor if you experience any adverse reaction to the medication.
Abnormal sensation
Application site swelling
Skin redness.
Is It safe with alcohol?
No interaction found
Are there any pregnancy warnings?
Xynova endo 200mg lozenges is probably safe to use during pregnancy.
Animal studies have shown low or no adverse effect on the foetus, however, there are limited human studies. Please consult your doctor.
Are there any breast-feeding warnings?
Xynova endo 200mg lozenges is probably safe to use during breastfeeding. Please consult your doctor.
Is it safe to drive while on this medicine?
There is no interaction between driving and consuming this drug. So dose alteration is not needed.
Does this affect kidney function?
There is no data available. Please consult doctor before consuming the drug.
Does this affect liver function?
There is no data available. Please consult doctor before consuming the drug.
Below is the list of medicines, which have the same composition, strength and form as Xylocaine 4% Injection , and hence can be used as its substitute.
Neon Laboratories Ltd
Xylocaine 4% Injection is a local anaesthetic and antiarrhythmic that works by stabilising the neuronal membrane by blocking the voltage gated sodium channels. This inhibits depolarisation of the postsynaptic nerve that prevents transmission of pain signals.
What are you using Xylocaine 4% Injection for?
Other
How much was the improvement?
Poor
How long did it take before seeing improvement?
Within 2 hours
How frequently did you take this medicine?
Once a day
How did you take this medicine?
With Food
What were the side effects of this medicine?
Abnormal sensation
Disclaimer: The information produced here is best of our knowledge and experience and we have tried our best to make it as accurate and up-to-date as possible, but we would like to request that it should not be treated as a substitute for professional advice, diagnosis or treatment.

Lybrate is a medium to provide our audience with the common information on medicines and does not guarantee its accuracy or exhaustiveness. Even if there is no mention of a warning for any drug or combination, it never means that we are claiming that the drug or combination is safe for consumption without any proper consultation with an expert.

Lybrate does not take responsibility for any aspect of medicines or treatments. If you have any doubts about your medication, we strongly recommend you to see a doctor immediately.

Popular Questions & Answers

I have rectal pain from the past 10 days and it was severe pain while passing stool and bleeding. I have consulted a doctor and he prescribed some Amoxicillin antibiotic and zerodol tablet along with one stool softener syrup freelex. After 3 days also it wasn't reduced and he gave me another antibiotic with more power along with zerodol. Now it is a bit okay. He says it's fissure and needs surgery. Does it really required? Around 3 years back the same situation has come and I have used drotin tablet along with flagyl 400 based on the prescription by another doctor n it got cured in 4-5 days. Can you please suggest the permanent solution for this problem?

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Hello dear lybrate-user, Warm welcome to Lybrate.com I have evaluated your query thoroughly.* Currently there is no need of surgery.* First of all, primary care has to be done with conservative management, when there is no recovery from that (which is very rare) then and then only surgery is mandatory.* Primary guidelines for better recovery. Drink plenty of liquids. Prefer soft, light diet with more of green leafy veg, whole grains, cereals,pulses, legumes,organic fresh fruits. Avoid all types of oily, spicy,non veg, hot beverages, junk foods, dairy fat. Manage to have smooth bowel passage with the help of bulk forming laxativesas Ispaghula husk with lukewarm drinking water. Tab. Ibuprofen (400 mg) after meals morning and evening after meals for control of pain, burning if no history of drug sensitivity. Xylocaine (5 %)jelly application over the anal part gives soothing action. Sitz bath (sitting in a tub filled with lukewarm water 5 minutes each 3 times a day and additionally after passing stools) helps.Avoid long drives, sitting prolong on hard surfaces. Control of blood sugar, cholesterol,body weight. Avoid smoking, alcohol if consuming.* And for your knowledge, fissure can again and again return after full recovery with surgery or without surgery, there is no permanent solution of that anywhere in any pathy of the universe. Hope this clears your query. Wishing you fine recovery. Welcome for any further assistance. Regards take care.
3 people found this helpful

Blood comes out with stool and some swelling is there on rectum. Please suggest what should I do.

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Blood comes out with stool and some swelling is there on rectum. Please suggest what should I do.
Hello dear lybrate-user, Warm welcome to Lybrate.com I have evaluated your query thoroughly.* Possible hemorrhoid condition.* Needs precise diagnosis with procto anoscopy evaluation via general surgeon.* Primary guidelines at present for better outcome Drink plenty of liquids. Prefer soft, light diet with more of green leafy veg, whole grains, cereals,pulses, legumes,organic fresh fruits. Avoid all types of oily, spicy,non veg, hot beverages, junk foods, dairy fat. Manage to have smooth bowel passage with the help of bulk forming laxativesas Ispaghula husk with lukewarm drinking water. Tab. Ibuprofen (400 mg) after meals for control of pain, burning if no history ofdrug sensitivity. Xylocaine (5 %)jelly application over the anal part gives soothing action. Sitz bath (sitting in a tub filled with lukewarm water 5 minutes each 3 times a day and additionally after passing stools) helps.Avoid long drives, sitting prolong on hard surfaces. Control of blood sugar, cholesterol,body weight. Avoid smoking, alcohol if consuming. Hope this clears your query. Wishing you fine recovery. Welcome for any further assistance. Regards take care.

I am 20 year old male studying. I have piles problem for past one year. At first it was painful and slightly bleeds then I didn't care for it because it didn't gave any problem during stools. So what should I do now? Leave it untreated or have to visit doctor?

MBBS, MS - General Surgery, FIAGES
General Surgeon, Gurgaon
I am 20 year old male studying. I have piles problem for past one year. At first it was painful and slightly bleeds t...
Hi piles can be painful and it an cause bleeding. Conservative measures like sitting in warm water that's is sitz bath ,taking laxatives like isabghol ,eating high fibre diet will solve your problem immediately ,but giving only temporary relief .definitive treatment for piles is surgical management .laser treatment for piles is definitive management .it is painless ,10 min procedure which solves your problem permanently .post surgery you will be on proper diet chart and certain pelvic floor exercises will be taught to you ,to avoid constipation in long run.

I am suffering from piles hence blood is not coming now but I am suffering from sever pain even can't sit also please suggest me.

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
I am suffering from piles hence blood is not coming now but I am suffering from sever pain even can't sit also please...
Hello dear lybrate-user, hi Warm welcome to Lybrate.com I have evaluated your query thoroughly.* This seems to be fissure condition rather than piles.* Needs confirmation with consultant surgeon, till you do the same, here are some very useful tips which will give you better ease: Drink plenty of liquids. Prefer soft, light diet with more of green leafy veg, whole grains, cereals,pulses, legumes,organic fresh fruits. Avoid all types of oily, spicy,non veg, hot beverages, junk foods, dairy fat. Manage to have smooth bowel passage with the help of bulk forming laxativesas Ispaghula husk with lukewarm drinking water. Tab. Ibuprofen (400) mg after meals for control of pain, burning if no history ofdrug sensitivity. Xylocaine (5 %)jelly application over the anal part gives soothing action. Sitz bath (sitting in a tub filled with lukewarm water 5 minutes each 3 times a day and additionally after passing stools) helps.Avoid long drives, sitting prolong on hard surfaces. Control of blood sugar, cholesterol,body weight. Avoid smoking, alcohol if consuming. Hope this clears your query. Wishing you fine recovery. Welcome for any further assistance. Regards take care.

Sir, since last 04 to 05 days there is a problem in my anus while passing stool in morning, there is looking like irritation and wart kind of in rectum also looks little blood there. Please suggest me some lotion and medicine.

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Hello dear lybrate-user, hi Warm welcome to Lybrate.com I have evaluated your query thoroughly.* Most probable diagnosis is fissure condition, needs confirmation with consultant surgeon.* Can provide primary guidelines for better outcome till you meet your doctor: Drink plenty of liquids. Prefer soft, light diet with more of green leafy veg, whole grains, cereals,pulses, legumes,organic fresh fruits. Avoid all types of oily, spicy,non veg, hot beverages, junk foods, dairy fat. Manage to have smooth bowel passage with the help of bulk forming laxativesas Ispaghula husk with lukewarm drinking water. Tab. Ibuprofen (400) mg after meals for control of pain, burning if no history ofdrug sensitivity. Xylocaine (5 %)jelly application over the anal part gives soothing action. Sitz bath (sitting in a tub filled with lukewarm water 5 minutes each 3 times a day and additionally after passing stools) helps.Avoid long drives, sitting prolong on hard surfaces. Control of blood sugar, cholesterol,body weight. Avoid smoking, alcohol if consuming. Hope this clears your query. Wishing you fine recovery. Welcome for any further assistance. Regards take care.

Popular Health Tips

All About Premature Ejaculation!

MBBS, PGDUS, Fellowship In Aesthetic Medicine, Advance Course In Diabetes - USA, MD - Medicine
Aesthetic Medicine Specialist, Delhi
Play video

The impact of psychological and biological factors on ejaculation

Good morning I'm Dr. Pradeep Aggarwal. I have done MBBS MD in many subjects of my interest you can consult me for diabetes for any chronic problem like Allergy, Asthma infection, sexual problem and also for a cosmetic and dermatological purpose. Today we'll talk about premature ejaculation.

premature ejaculation is a disease in India almost 1 out of 3 men suffer from it and although it is a treatable disease, many men find difficulty in presenting their symptoms. They feel embarrassed about it,but if you seek treatment there is definitely a cure. Basically as per the WHO as per the psychological Indians engine of psychology guideline.

there are three criteria when we say the patient is suffering from premature ejaculation.

On the basis of that, we will decide the patient is suffering from premature ejaculation.

  • first when a patient is unable to control or unable to delay his declaration when he's already emasculate with in one minute of intercourse and if he is unable to satisfy his partner in sexual activities. So we will talk about the cause. Basically, we divide cause into two types that are biological cause and other is emotion and Secretary emotional causes come when a person is in fear that someone might come and see him. Sometimes person feels guilty in having sex that is also a psychological calls and sometimes he may have anxiety or performance issues that make him unable to have a sex or sex with a proper caliber sometimes that is there is biological cause also like abnormal brain chemicals abnormal hormone thyroid issues, infections, inflammation and many genetic issues also make him unable to do sex with a proper of ejaculation period. So these are basic cause that is reason of premature ejaculation.

premature ejaculation as concern can be divided into two parts

  • one is primary premature ejaculation that occurs when persons have difficulty in having sex or have a pre ejaculation problem for the first time when he has sex and
  • second is previously if he has normal sexual habits and suddenly he feels symptom of premature ejaculation that is called as secondary premature ejaculation

treatment of premature ejaculation can be divided into five parts-

  • first concerned with a thorough medical revolution that what is causing premature ejaculation, we have to see the patient we have a certain test that we prescribe to the patient and a thorough evaluation is done to decide what is causing the premature ejaculation.
  • Then the treatment part can decide first always first in the sexual therapy that we guide patient that whenever you have sex with your try to make her wife her girlfriend to reach the climax excite to the level that he is at the end so that they can satisfy him at that time.
  • Second is the controlling breath and thought cycle we always auspicious take a long breath when they have sex or when they are doing premature ejaculation by taking a long breath they can delete ejaculation periods.
  • We can also prescribe the patient some exercise like squish technique. Squish technique is perfect items can lead to better treatment of ejaculation without any medicine patient just have to when is just about to ejaculate he has to press his penis low level that he was unable to ejaculate and then when the arch pass he can place his penis and then after again 30 seconds he can continue with the sex. By that how he can regulate his ejaculation habit and he can delay the ejaculation periods by doing it for long time.
  • Apart from this certain medicines like antidepressants are also there some oral anesthetics are also available that can delay the ejaculation periods vision can apply that anesthetics like lidocaine and xylocaine jelly over there penis and all the time it will decrease the sensitivity of the penis and they are able to do sex for the long time.

That is how we can treat premature ejaculation if you have any further queries or any question you can consult me on lybrate.

3447 people found this helpful

Piles - Diagnosis and Treatment

MBBS, MS - General Surgery
General Surgeon, Bangalore
Piles - Diagnosis and Treatment

Piles or haemorrhoids are swollen veins in the rectum or anus. They can have a lot of possible causes, but the exact reason is still unknown. The one most common reason that researchers cite is the excessive straining during bowel movement and increased pressure on the veins during pregnancy. Some of the common signs of this condition include discomfort, bleeding, and itching. A clot can be witnessed occasionally. There could be swelling around the anus as well.

How is a pile diagnosed?
Doctors often recognize this condition just by doing a physical exam of the rectum. By lubricating the glove and inserting a finger into the rectum, a doctor can gauge any unusual growth around the rectum area. A doctor might also use a sigmoidoscopy or a proctoscopy to witness the lower portion of the colon. Apart from this, a doctor might prescribe a colonoscopy, if he fathoms that there is a possibility of colorectal cancer or a disease related to the digestive system.

Treatment of piles

  1. Medication: In case of mild discomfort, a doctor might prescribe over-the-counter pads, ointments, creams or suppositories. Products such as these contain lidocaine, witch hazel or hydrocortisone that can relieve a person from itching and pain. One should stop consuming over-the-counter medicine, if there is no change in the condition.
  2. Haemorrhoid thrombectomy: If a clot has appeared along with a pile in the rectum, a doctor can remove it by making an incision and draining the clot. This can fetch instant relief. The best time to do this is within 72 hours of clot formation.
  3. Minimally invasive procedures: 
    • Rubber band litigation: This form of surgery involves placing of a couple of rubber band at the base of the piles to cut off blood circulation. In due course, the haemorrhoids fall off. Although this form of treatment works for many people, the patient has the risk of bleeding within few days of placing the rubber band.
    • Sclerotherapy: This form of treatment involves injecting a chemical into the haemorrhoid. The chemical shrinks the piles within few days. There is hardly any pain involved with sclerotherapy.
  4. Surgical procedure:
    • Haemorrhoidectomy: This is the process by which a surgeon eradicates the excess tissue that might be causing the piles. The patient is sedated before performing this procedure. Some amount of pain is experienced after the procedure is over. The temporary difficulty of urination can be faced by a patient after this procedure.
    • Stapled hemorrhoidopexy: This surgery is only performed for internal haemorrhoids. The process involves blocking the blood supply. The process of stapling has less pain compared to a Haemorrhoidectomy. On the flip side, studies have shown that this procedure has an increased chance of recurrence of haemorrhoids.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2908 people found this helpful

Lip Augmentation - Facts You Must Know About It!

MCh - Plastic and Reconstructive Surgery, MS - General Surgery, MBBS
Cosmetic/Plastic Surgeon, Delhi
Lip Augmentation - Facts You Must Know About It!

Lip augmentation is a restorative (cosmetic) procedure where your lips are reshaped to make them appear fuller. Cosmetic procedures are done for aesthetic improvement, but surgical lip augmentation is performed if the lips are affected by any congenital condition or tissue trauma.

Dermal fillers are mostly used to enlarge the lips. Previously, collagen was the most popular filler, but currently, due to various health reasons, doctors do not use it as often as before. Now, hyaluronic acid fillers are the most popular dermal filler.

Hyaluronic acid is naturally available in your body, especially in your neural, epithelial and connective tissues. The fillers that doctors presently use are chemically similar to hyaluronic acid. It is extremely beneficial in adding volume to your lips.

Applications of Hyaluronic acid

  • Hyaluronic acid fillers improve your lips’ appearance by boosting their shape, structure and volume.
  • The effects of such fillers last approximately for six months; you would require more injections after that.
  • Restylane and Juvederm are the most popular hyaluronic acid fillers used currently. These also contain lidocaine in them, which is a local anaesthetic.

Hyaluronic acid fillers also include the following benefits:

  • The amount of filler to be injected is easily controllable, so the doctor can regulate the amount of volume to create.
  • The injections are given at a steady pace, so the development can be carefully monitored to achieve the desired result.
  • Any bump or lump caused by moving the lips too much is easier to correct.
  • In relation to other dermal fillers, there will be reduced swelling and bruising.
  • Results last for a longer duration, but they are not permanent.
  • Collagen fillers required an allergy test before the procedure could begin, but that is not the case with hyaluronic fillers. Hyaluronic acid fillers are not allergens since they are made from similar substances found in the body.

Risks of lip augmentation
Like every surgical procedure, lip augmentation too has certain risks involved. Some of the contraindications (situational dangers of certain drugs or procedures) include:

In case you have a concern or query you can always consult an expert & get answers to your questions!

2784 people found this helpful

Dermabrasion: Procedures and Results

MCh - Plastic and Reconstructive Surgery, MS - General Surgery, MBBS
Cosmetic/Plastic Surgeon, Chennai
Dermabrasion: Procedures and Results

Dermabrasion is a skin related treatment used by cosmetic surgeons and dermatologists to cure a number of ailments that may leave your skin looking less than healthy. This method basically employs a technique that removes the upper layers of your skin with the help of a rough edged diamond wheel or a wire brush. These edges are called a burr or a fraise.

Here is everything you need to know about the procedure as well as the results that it can yield:

  • Areas and Conditions: The most common areas where this procedure is conducted include the face as well as the neck. It is mostly used to treat people who want to remove fine lines that form around the eyes and the mouth, as well as patients who are suffering from acne scars and other inflammation causing skin ailments as well as abrasions due to injuries.
  • Preparation: The procedure includes cleaning and marking the area that is being treated. This is the first step that helps in seeing exactly what needs to fixed, the extent of the damage and the intensity of the treatment to be employed. Following this process, the doctor will administer a local anaesthesia such as, Lidocaine that will numb the area before the actual treatment begins so that the patient does not undergo any discomfort. Also, with this purpose in mind, the dermatologist may also apply ice packs on the face and neck of the patient so as to make the skin even more numb and remain like that for a longer period of time. Additionally, the skin may be sprayed with a freezing cryogenic spray in order to retain the numbness and keep the skin firm enough for effective treatment. If the doctor is going to treat deeper abrasions or the entire face, then pain killers and general anaesthesia may be used.
  • Procedure: To begin with, a small area is exposed to the treatment at a time, rather than the entire area or face at one time. After the freezing spray is administered, the doctor may run the rotating brush or burr to remove the top layers of the skin. Gauze will be kept handy so as to stem any bleeding that may take place during the process. Finally, the area will be covered with the help of ointment and dressing.
  • Results: The recovery time is said to take anywhere between five to eight days. But this also depends on the severity of condition that was treated, as well as the area that was covered. Little or no pain may follow and regular cleaning will be required. To prevent re-occurrence or re-growth of the problem, follow up visits to the dermatologist will be required.
1 person found this helpful

Premature Ejaculation: What Should You Know About It?

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
Premature Ejaculation: What Should You Know About It?

My last article gave insight on the non-medical methods of controlling premature ejaculation Now, as a wrap up on this topic, I will highlight the options of medical treatments available for managing P.E. However, take it as a warning that you must consult your doctor before trying out any of these methods and medicines, because more often than not, such drugs and medicines have their side effects that can adversely bother your health.

By now we know that Premature ejaculation (PE) occurs when a man reaches peak of sexual excitement and ejaculates before he actually wants it to happen, thus, leaving his partner deprived of the sexual pleasure that she deserves. Even the most empathetic female partner would not like his man to leave her unsatisfied in bed.  Sooner or later this problem becomes a medical problem, reduces the warmth in their relationship.

Several factors including psychological problems such as anxiety; biological problem like penile hypersensitivity, hormonal imbalance (e.g. thyroid problem); behavioural problem like, habituation of quick sex/masturbation, etc may be held responsible for causing PE.

Medical (Allopathic) therapy for PE treatment:

Drugs used for managing premature ejaculation reduce sensitivity and anxiety, improve blood flow and even affect some chemical mediators present in the brain. These class of drugs include local anaesthetics, antidepressants and phosphodiesterase-5 inhibitors.

Anaesthetic compounds were the first medical treatment proposed for PE management. They were applied topically to the surface of skin. Lidocaine-prilocaine sprays or creams decrease the sensation of the penis and increase the time taken to ejaculate during vaginal penetration. These sprays/ creams are applied 10 to 20 minutes prior to sexual activity. Side effects of topical agents include partial loss of sensation of penis, absorption in vagina resulting in vaginal numbness and irritation.

Earlier agents like Alpha Amino Benzoate and Phenoxybenzamine were used to prolong duration of intercourse, but they were associated with severe side effects.

It has been found that Serotonin (a chemical in brain) levels were deficient in PE patients. Treatment medications include Selective Serotonin Reuptake Inhibitors (SSRIs), which interact with a receptor (5-HT2C) present in brain and increases the production of Serotonin. They also help in reducing anxiety and depression associated with PE. Through this mechanism, they prolong the time to reach ejaculation. Several SSRIs have increasingly become used as 'off-label' for PE.

Among the available SSRIs, Paroxetine-Dapoxetine is more beneficial with lesser side effects as compared to other SSRIs. These medications are associated with sexual side effects including decreased fertility and erectile dysfunction. Dapoxetine is a recent SSRI which acts quickly and cleared rapidly from the body. Adverse effects with SSRIs are usually minor and include fatigue, mild nausea, loose stools and sweating. Other side effects may include decreased sexual urge and increased tendency to suicide, especially with long-term use of Paroxetine.

Another potential medical treatment option for PE are class of medications which increase the blood flow by dilating the blood vessels of penile region and prolong the PE. But headache, dizziness, flushing, body-ache associated with them have limited their use in PE.

At present, clinicians need to consider all treatment modalities when evaluating a man with PE, as each patient may respond differently and experience variable side effects. Additional and more effective therapies need to be developed having least side effects.

Ayurvedic therapy for PE treatment:

Vajikaran in Ayurveda is an important treatment modality which increases sexual capacity and improves health. In Sanskrit, Vaji means horse, the symbol of sexual potency and performance thus Vajikaran means producing a horse's vigour, particularly the animal's great capacity for sexual activity in the individual. Vajikaran therapy reenergizes all the seven dhatus (body elements), and restores equilibrium and health. It also offers a solution to minimize the shukra (sperm and ovum) defects.

There are many formulations which are used in Vajikaran. Some of the commonly used formulations include Vrihani GutikaVrishya Gutika, Vajikaranam Ghritam and Upatyakari Shashtikadi Gutika.

Vrihani Gutika is one of the potent formulations while Vrishya Gutika is highly potent aphrodisiac used in treatment of PE. Vajikaranam Ghritam enhances the strength of penis. Upatyakari Shashtikadi Gutika is useful for the enhancement of the fertility.

Also, Chapdraprabha Vati and Kaunch Pak are known to increase sexual vigour and semen consistency helping in increase in sexual timing.

So, with this concluding article, I wrap up my knowledge and experience in treating patients suffering from premature ejaculation. Take care, and stay healthy!

In case you have a concern or query you can always consult an expert & get answers to your questions!

7137 people found this helpful

Table of Content

About Xylocaine 4% Injection
When is Xylocaine 4% Injection prescribed?
What are the side effects of Xylocaine 4% Injection ?
Key highlights of Xylocaine 4% Injection
What are the substitutes for Xylocaine 4% Injection ?