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Are one or two dangerous? Lidocaine and topical anesthetic exposures in children

Liesl A Curtis1, Teresa Sullivan Dolan, H Edward Seibert

  • 1Department of Emergency Medicine, Georgetown University Hospital, Washington, DC, USA.

The Journal of Emergency Medicine
|February 19, 2008
PubMed

Insights

Topical anesthetic overdose is a serious risk for young children, even from common over-the-counter products. Accidental exposure can lead to severe toxicity and even death in children under six years old.

Area of Science:

  • Pediatric Toxicology
  • Pharmacology

Background:

  • Topical anesthetics are widely available in various formulations, including over-the-counter products.
  • In 2003, the American Association of Poison Control Centers received 8576 reports of exposures to local/topical anesthetics, with 67% involving children under six years old.

Purpose of the Study:

  • To review the literature on topical anesthetic exposures in children younger than 6 years old.
  • To analyze data on toxicity and fatalities associated with these exposures in young children.

Main Methods:

  • Literature review of PubMed (English language) and POISINDEX.
  • Analysis of American Association of Poison Control Centers annual reports from 1983 to 2003.

Main Results:

  • Seven deaths were reported in children under six years old due to topical anesthetic toxicity.
  • Toxicity can occur via absorption, ingestion, or aspiration, and from both accidental and therapeutic errors.
  • Even small amounts, as little as a teaspoon, can be toxic in this age group.

Conclusions:

  • Despite a low number of deaths, topical anesthetic toxicity poses a significant risk to young children.
  • Readily available non-prescription topical anesthetics can cause severe adverse events in children under six.
  • Awareness and careful administration are crucial to prevent toxicity in pediatric populations.

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