Difference between revisions of "Local anesthetic systemic toxicity"

(Diagnosis)
Line 10: Line 10:
 
**Auditory changes
 
**Auditory changes
 
**Metallic taste
 
**Metallic taste
**Seizures or drowsiness
+
**[[Seizures]] or drowsiness
 
**Coma
 
**Coma
 
**Respiratory arrest
 
**Respiratory arrest
Line 21: Line 21:
 
***Bradycardia
 
***Bradycardia
 
***Conduction block
 
***Conduction block
***Asystole
+
***[[Asystole]]
  
 
==Management==
 
==Management==

Revision as of 04:23, 28 April 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

Management

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

See Also