Lidocaine
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ECG P-wave inverted and increased heart rate following drug toxicity: case report In a retrospective cohort study of 372 female patients conducted between September 2015 and October 2016, one female patient [age not stated] was described, who exhibited increased heart rate and ECG inverted P-wave secondary to drug toxicity following local anaesthetic treatment with lidocaine. The female patient had stage 2 pelvic organ prolapse and was admitted for the scheduled vaginal reconstruction with hysterectomy. Intraoperatively, she was given IV lidocaine 2% by the anesthesiologist, and then vaginal injection of lidocaine 1% along with epinephrine by the surgeon. She received a toxic dose of lidocaine at 450mg with a calculated weight-based toxicity dose of 392mg. Approximately 150 min after the induction of anaesthesia, she exhibited intraoperative ECG changes characterised by inverted P-wave. Her heart rate also increased from baseline to 90s. The female patient was treated with metoprolol and fentanyl with improvement in condition and resolution of the ECG abnormalities. No further intervention or evaluation was performed during admission. Willis-Gray MG, et al. Lidocaine Use in Vaginal Surgery and Risk of Toxicity. Female Pelvic Medicine and Reconstructive Surgery 26: 546-549, No. 9, Sep 2020. Available 803515226 from: URL: http://doi.org/10.1097/SPV.0000000000000622
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Reactions 14 Nov 2020 No. 1830
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