acute lidocaine toxicity: a case series

Introduction: parenteral form of lidocaine is the best-known source of lidocaine poisoning. this study aimed to evaluate the characteristics of acute lidocaine toxicity . methods: in this retrospective cross-sectional study, demographics, clinical presentation, laboratory findings, and outcome of patients intoxicated with lidocaine (based on icd10 codes) admitted to loghman hakimhospital, during april 2007 tomarch 2014 were analyzed. results: 30 cases with the mean age of 21.83 ± 6.57 year were studied (60% male). all subjects had used either 6.5% lidocaine spray or 2% topical formulations of lidocaine. the mean consumed dose of lidocaine was 465± 318.17 milligrams. the most frequent clinical presentations were nausea and vomiting (50%), seizure (33.3%), and loss of consciousness (16.7%). 22 (73.3%) cases had normal sinus rhythm, 4 (13.3%) bradycardia, 2 (6.7%) ventricular tachycardia, and 2 (6.7%) had left axis deviation. 11 (36.6%) cases were intubated and admitted to intensive care unit (icu) for 6.91 ± 7.16 days. three patients experienced status epilepticus that led to cardiac arrest, and death (all cases with suicidal intention). conclusion: based on the results of this study, most cases of topical lidocaine toxicity were among < 40-year-old patients with a male to female ratio of 1.2, with suicidal attempt in 90%, need for intensive care in 36.6%, and mortality rate of 10%.