Lidocaine-induced central nervous system toxicity during implantable cardioverter defibrillator placement - A case report and literature review

Rev Port Cardiol. 2023 May;42(5):483.e1-483.e4. doi: 10.1016/j.repc.2020.07.025. Epub 2023 Mar 21.
[Article in English, Portuguese]

Abstract

Lidocaine, a local anesthetic, is commonly used in various medical procedures. Despite its widespread use, most physicians are not familiar with the life threatening presentation of lidocaine toxicity and its treatment. Our case demonstrates successful management of local lidocaine-induced systemic toxicity in a 53-year-old female during insertion of an implantable cardioverter defibrillator. Our goal was to raise awareness of the risks and symptoms of local anesthetic toxicity, educate regarding the site of administration and dose of anesthetic delivery as independent risk factors for systemic toxicity and highlight the use of intravenous lipid emulsion as an antidote.

Keywords: Anestético local; Emulsão lipídica; Lidocaine; Lidocaína; Lipid emulsion; Local anesthetic; Toxicidade; Toxicity.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Anesthetics, Local / adverse effects
  • Central Nervous System
  • Defibrillators, Implantable* / adverse effects
  • Female
  • Humans
  • Lidocaine* / adverse effects
  • Middle Aged
  • Risk Factors

Substances

  • Lidocaine
  • Anesthetics, Local