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[Severe local anesthetic intoxication in an infant undergoing circumcision]
E Doye1, F-P Desgranges2, D Stamm1
1Service de réanimation pédiatrique, hôpital Femme-Mère-Enfant, hospices civils de Lyon, université Claude-Bernard Lyon 1, 59, boulevard Pinel, 69677 Bron, France.
Summary
Local anesthetic systemic toxicity is a rare but serious risk during regional anesthesia. A 4-month-old infant experienced seizure and cardiac arrest after a penile nerve block, highlighting the need for vigilance.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Toxicology
Background:
- Regional anesthesia, including penile nerve blocks, is frequently used for infant circumcision.
- Local anesthetic systemic toxicity (LAST) is a rare but potentially fatal complication.
Observation:
- A 4-month-old infant developed generalized tonic-clonic seizure and cardiac arrest post-circumcision.
- These events occurred after a bilateral dorsal penile nerve block using lidocaine in an outpatient setting.
Findings:
- Severe local anesthetic systemic toxicity (LAST) was diagnosed as the cause of the infant's critical condition.
- The case demonstrates a severe reaction to lidocaine administered via bilateral dorsal penile nerve block.
Implications:
- This case underscores the critical importance of recognizing and managing LAST in pediatric patients undergoing regional anesthesia.
- It highlights the potential risks associated with local anesthetic administration in non-hospital settings.
- Prompt recognition and management are crucial for improving outcomes in LAST cases.