Local anesthetic systemic toxicity

Revision as of 11:11, 15 July 2013 by Rossdonaldson1 (talk | contribs) (See Also)

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

Lidocaine