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Recurrent seizures in a neonate after lidocaine administration
1Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, Md. 21205, USA.
Objective:
We report recurrent seizures in a neonate after intravenous lidocaine administration at the recommended dose for intubation and supplementation of general anesthesia.
Study Design:
Further evaluation of this case included determination of serum lidocaine level, serum electrolyte levels, and arterial blood gas values; cerebral spinal fluid analysis; an electroencephalogram; head ultrasonography; brain stem auditory evoked response testing; and a complete developmental evaluation. Previously published literature discussing lidocaine toxicity and pharmacokinetics is reviewed.
Results:
The lidocaine level in the patient was 0.3 mg/L 2 hours after the last dose was administered. Results of the remaining studies were within normal limits, and the patient had no additional seizures several months after birth.
Conclusion:
We caution that lidocaine administration to newborn infants at previously accepted doses may result in life-threatening side effects, including prolonged seizures.