Difference between revisions of "Local anesthetic systemic toxicity"

(See Also)
Line 23: Line 23:
 
***Asystole
 
***Asystole
  
===Management===
+
==Management==
 
*Lipid emulsion
 
*Lipid emulsion
 
**1.5 mL/kg bolus over 1 minute
 
**1.5 mL/kg bolus over 1 minute
Line 29: Line 29:
  
 
==See Also==
 
==See Also==
[[Lidocaine]]
+
*[[Lidocaine]]
 +
*[[Nerve Blocks (Main)]]
  
 
[[Category:Tox]]
 
[[Category:Tox]]
 
[[Category:Drugs]]
 
[[Category:Drugs]]

Revision as of 07:30, 3 January 2014

Background

  • Complication of lidocaine injection (accidental into systemic circulation)
    • 0.2% of nerve blocks
  • Occurs within minutes of injection
    • 75% occuring within 5 minutes

Diagnosis

  • CNS symptoms
    • Agitation
    • Auditory changes
    • Metallic taste
    • Seizures or drowsiness
    • Coma
    • Respiratory arrest
  • Cardiovascular
    • First excitation
      • Tachycardia
      • Ventricular dysrhythmia
      • Hypertension
    • Followed by depression
      • Bradycardia
      • Conduction block
      • Asystole

Management

  • Lipid emulsion
    • 1.5 mL/kg bolus over 1 minute
    • Then, 15 mL/kg per hour x 20-minute infusion

See Also