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Lidocaine toxicity secondary to postoperative bladder instillation in a pediatric patient
C R Clapp1, W B Poss, B G Cilento
1Department of Pediatrics, Naval Medical Center San Diego, San Diego, California 92134-5000, USA.
Insights
Systemic lidocaine toxicity can occur in children after intravesical anesthetic use for bladder spasms. This case highlights the importance of monitoring for adverse events in pediatric urology patients.
Area of Science:
- Urology
- Anesthesiology
- Pediatric Medicine
Background:
- Intravesical administration of local anesthetics is common in urologic procedures.
- Previous literature has not reported toxicity associated with this method.
Observation:
- A 2.5-year-old girl experienced systemic lidocaine toxicity after intravesical treatment for postoperative bladder spasms.
- The patient presented with a generalized seizure necessitating endotracheal intubation.
Findings:
- This case represents a rare instance of severe adverse reaction to intravesical lidocaine in a pediatric patient.
- Prompt supportive care led to the patient's full recovery.
Implications:
- Clinicians should be vigilant for potential systemic toxicity even with commonly used intravesical anesthetics.
- This case underscores the need for careful dosing and monitoring in pediatric urology to prevent lidocaine toxicity.
- Further research into safe anesthetic protocols for pediatric bladder conditions is warranted.
Abstract:
The intravesical use of local anesthetics has been described for a variety of urologic procedures with no previous reports of toxicity. We recently took care of a 2.5- year-old girl with systemic lidocaine toxicity following treatment for postoperative bladder spasms. The patient developed a generalized seizure requiring endotracheal intubation but recovered fully with supportive care. We report the clinical details of this case as well as a brief review of lidocaine toxicity.