Lidocaine overdose
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Local anaesthetic systemic toxicity and cardiac arrest secondary to drug administration error: case report In a single-centre, retrospective study of 394 patients treated with lidocaine between February 2013 and December 2017, a patient [age and sex not stated] was described, who developed local anaesthetic systemic toxicity and cardiac arrest secondary to an accidental overdose of lidocaine following inadvertent administration of a rapid lidocaine bolus. The patient, who had undergone an unspecified surgery, started receiving IV infusions of lidocaine 1 mg/kg/h for postoperative analgesia. However, the patient subsequently developed a cardiac arrest due to inadvertent rapid administration of lidocaine bolus: on arrival from the recovery room, the patient’s lidocaine infusion was transiently disconnected from the pump for shifting the patient from the stretcher to the bed. However, this caused lidocaine to run freely through the IV line. The patient inadvertently received approximately 2000mg of IV lidocaine over 20 minutes. At presentation, the patient exhibited altered sensorium, hypotension and decreased consciousness. The patient was subsequently diagnosed with local anaesthetic systemic toxicity. Therefore, the patient was treated with intralipid therapy and cardiopulmonary resuscitation. The treatment led to the spontaneous return of circulation, and the patient made a complete recovery. The local anaesthetic systemic toxicity and cardiac arrest were thus attributed to the accidental overdose of lidocaine following inadvertent administration of the rapid lidocaine bolus. De Oliveira K, et al. Intravenous Lidocaine for Acute Pain: A Single-Institution Retrospective Study. Drugs - Real World Outcomes 7: 205-212, No. 3, Sep 2020. Available 803507249 from: URL: http://doi.org/10.1007/s40801-020-00205-8
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Reactions 17 Oct 2020 No. 1826
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