Lidocaine toxicity following subcutaneous administration

Area of Science:

• Toxicology
• Pediatric Neurology
• Pharmacology

Background:

• Lidocaine is a common local anesthetic.
• Subcutaneous administration can lead to systemic toxicity.
• Seizures are a severe manifestation of lidocaine toxicity.

Observation:

• A 2-year-old girl experienced grand mal seizures after massive subcutaneous lidocaine administration.
• The patient was treated with intravenous diazepam and intubation.
• She was observed for 24 hours.

Findings:

• The child survived the lidocaine toxicity.
• No neurological sequelae or seizure recurrence were observed during a ten-month follow-up.
• The case highlights the potential for severe central nervous system effects from lidocaine.

Implications:

• This case underscores the importance of careful dosing and administration of lidocaine, especially in pediatric patients.
• Understanding lidocaine toxicity, including its central nervous system, cardiac, and hematologic effects, is crucial for emergency management.
• Awareness of potential drug interactions that potentiate lidocaine toxicity is vital for patient safety.