Intravenous lidocaine overdosage in a child

A six-year-old child inadvertently received an IV solution containing lidocaine HCl. An estimated total dose of 1.2 gm. was administered over approximately an hour. The child had asystole and grand mal seizures associated with lidocaine serum concentration of 19.2 mcg/ml. The pharmacokinetics of lidocaine overdose and treatment are discussed.