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Lidocaine toxicity following subcutaneous administration
Insights
A 2-year-old girl recovered from severe seizures caused by excessive lidocaine injection. Prompt treatment with diazepam and intubation led to a full recovery with no lasting effects after ten months.
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.
Abstract:
A case of a 2-year-old girl who survived grand mal seizures secondary to toxicity from massive subcutaneous administration of lidocaine is presented. She was treated with intravenous diazepam and was intubated. After 24 hours of observation she was discharged, and there have been no sequelae or recurrence of seizure activity during ten months follow up. Central nervous system, cardiac, and hematologic effects of lidocaine toxicity are discussed. Drug interactions that may potentiate lidocaine toxicity are listed.