Serum lidocaine levels during arthroscopy using continuous irrigation with lidocaine

Forty patients with symptoms of internal derangement of the knee were examined arthroscopically under local anesthesia using a continuous irrigation solution of 0.2% lidocaine. Serum levels were measured during and following the procedure to determine peak levels obtained and to assure that toxic levels were not exceeded. The procedure was well tolerated by all patients and found to be adequate by the surgeon. No procedure was terminated because of discomfort. Lidocaine levels ranged from undetectable to 2.5 micrograms/ml with an average of 0.6 microgram/ml. No complications of lidocaine toxicity were noted by the anesthesiologist or the operating surgeon. This technique provides a safe and efficient method of meeting the demands for diagnostic and therapeutic arthroscopy in ambulatory patients.