Local anesthetic systemic toxicity
Revision as of 11:09, 15 July 2013 by Rossdonaldson1 (talk | contribs)
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
- First excitation
Management
- Lipid emulsion
- 1.5 mL/kg bolus over 1 minute
- Then, 15 mL/kg per hour x 20-minute infusion