Local anesthetic systemic toxicity: Difference between revisions
No edit summary |
|||
| Line 10: | Line 10: | ||
**Auditory changes | **Auditory changes | ||
**Metallic taste | **Metallic taste | ||
**Seizures or drowsiness | **[[Seizures]] or drowsiness | ||
**Coma | **Coma | ||
**Respiratory arrest | **Respiratory arrest | ||
| Line 21: | Line 21: | ||
***Bradycardia | ***Bradycardia | ||
***Conduction block | ***Conduction block | ||
***Asystole | ***[[Asystole]] | ||
==Management== | ==Management== | ||
Revision as of 04:23, 28 April 2014
Background
- Complication of lidocaine injection (accidental into systemic circulation)
- 0.2% of nerve blocks
- Occurs within minutes of injection
- 75% occuring within 5 minutes
Diagnosis
- CNS symptoms
- Agitation
- Auditory changes
- Metallic taste
- Seizures or drowsiness
- Coma
- Respiratory arrest
- Cardiovascular
- First excitation
- Tachycardia
- Ventricular dysrhythmia
- Hypertension
- Followed by depression
- Bradycardia
- Conduction block
- Asystole
- First excitation
Management
- Lipid emulsion
- 1.5 mL/kg bolus over 1 minute
- Then, 15 mL/kg per hour x 20-minute infusion