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Toxicity of local anesthetics in infants and children

C B Berde1

  • 1Harvard Medical School, Boston, Massachusetts.

The Journal of Pediatrics
|May 1, 1993
PubMed

Insights

Local anesthetics offer safe pain relief for children when used correctly. Adhering to dosage limits and avoiding accidental injections are crucial for preventing toxicity in pediatric patients.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Clinical Toxicology

Background:

  • Local anesthetics are widely used for anesthesia and analgesia in pediatric patients.
  • Despite a good safety record, toxicity concerns necessitate careful administration.
  • Safe use requires understanding systemic drug handling and dosage limits.

Purpose of the Study:

  • To review the safe use of local anesthetics in pediatrics.
  • To highlight potential toxicity issues and their causes.
  • To emphasize the importance of adhering to strict dosage guidelines.

Main Methods:

  • Review of existing literature on local anesthetic toxicity in children.
  • Analysis of factors contributing to adverse events.
  • Emphasis on quantitative dosing strategies.

Main Results:

  • Most toxic reactions result from inadvertent intravascular injection or overdosage.
  • Systemic uptake, distribution, and clearance significantly influence toxicity.
  • Unlike opioids, local anesthetics require precise dose limitation.

Conclusions:

  • Local anesthetic administration within established safety guidelines should be encouraged in pediatrics.
  • Healthcare providers must be informed about dosage limits and toxicity management.
  • Strict adherence to quantitative limits is essential for safe pediatric use.

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