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Lidocaine toxicity secondary to local anesthesia administered in the community for elective circumcision

Khaled Menif1, Ammar Khaldi, Asma Bouziri

  • 1Pediatric Intensive Care Unit, Children's Hospital of Tunis, Tunis, Tunisia.

Fetal and Pediatric Pathology
|November 9, 2011
PubMed

Insights

Three infants experienced systemic lidocaine toxicity after subcutaneous lidocaine for circumcision anesthesia. All infants had seizures but recovered fully with supportive care, highlighting potential risks of local anesthetics in neonates.

Area of Science:

  • Pediatric Anesthesiology
  • Clinical Toxicology
  • Neonatal Medicine

Background:

  • Regional anesthesia using lidocaine is common for elective infant circumcision.
  • Systemic lidocaine toxicity can occur following regional anesthesia.
  • Monitoring for adverse events is crucial in pediatric anesthesia.

Observation:

  • Three previously healthy infants (23 days, 6 weeks, 3 months) developed systemic lidocaine toxicity.
  • Toxicity occurred after subcutaneous lidocaine administration for regional anesthesia during circumcision.
  • All infants presented with generalized seizures requiring endotracheal intubation.

Findings:

  • The infants experienced severe central nervous system toxicity.
  • Full recovery was achieved with comprehensive supportive care.
  • This indicates the potential for significant adverse events even with standard procedures.

Implications:

  • Subcutaneous lidocaine administration for regional anesthesia in infants carries a risk of systemic toxicity.
  • Prompt recognition and supportive care are vital for managing lidocaine-induced seizures in neonates.
  • Further research into safer anesthetic techniques or dosing for infant circumcision may be warranted.

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