Intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures is an unapproved use, and there have been post-marketing reports of chondrolysis in patients receiving such infusions. CNS toxicity has been observed (constant monitoring of the patient’s state of consciousness should be performed following each local anesthetic injection; at such times, restlessness, anxiety, tinnitus, dizziness, blurred vision, tremors, depression, or drowsiness may be early warning signs of CNS toxicity). Respiratory arrest reported. Convulsions due to systemic toxicity leading to cardiac arrest have also been reported, presumably following unintentional intravascular injection. Use with caution in patients with cardiovascular disease, compromised blood supply or with hepatic impairment. Use with caution in acutely ill, debilitated patients, elderly or children (reduce dose consistent with age and physical status). Do not use solutions containing preservatives for caudal or epidural block. Intravascular injections should be avoided. A test dose is recommended prior to epidural administration (prior to initial dose) and all reinforcing doses with continuous catheter technique. Clinicians using local anesthetic agents should be well trained in diagnosis and management of emergencies that may arise from the use of these agents. Resuscitative equipment, oxygen, and other resuscitative drugs should be available for immediate use.