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Convulsion and Atrial Fibrillation after Transforaminal Cervical Epidural Lidocaine Injection.

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A patient experienced convulsion and atrial fibrillation after a cervical epidural injection of lidocaine (local anesthetic and antiarrhythmic). Symptoms resolved without lasting effects, highlighting potential risks of this common procedure.

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Area of Science:

  • Anesthesiology
  • Cardiology
  • Neurology

Background:

  • Lidocaine is a common local anesthetic and antiarrhythmic.
  • Its use in epidural anesthesia is increasing.
  • This trend introduces novel risks not seen with traditional applications.

Observation:

  • A case of convulsion and atrial fibrillation occurred post-transforaminal cervical epidural injection.
  • The injection involved 2 milliliters of 2% lidocaine (40 milligrams).
  • The patient's serum lidocaine level was negative.

Findings:

  • The patient's symptoms resolved completely with no long-term sequelae.
  • Cervical epidural injections are frequently used for radicular pain management.

Implications:

  • Medical providers must be aware of potential complications associated with cervical epidural lidocaine injections.
  • This case underscores the importance of vigilance for adverse events even with negative serum drug levels.