LIDOCAINE TOXICITY AFTER SUBCUTANEOUS INFILTRATION IN CHILDREN UNDERGOING CARDIAC-CATHETERIZATION

The administration of subcutaneous lidocaine as a local anesthetic is readily observed in dental, orthopedic, and minor surgical procedures as well as for the insertion of monitoring catheters. The use of any local anesthetic presents significant risk to the patient, and extreme caution should be exercised in its administration1. Significant complications resulting from lidocaine toxicity have been reported.2-5 However, it is not well recognized that an elevated serum lidocaine level may result from the subcutaneous infiltration of lidocaine. Although the guidelines for the subcutaneous infiltration of lidocaine are established for children, these recommendations are often exceeded. In our study of 10 sequential patients, we describe 2 cases of lidocaine toxicity that occurred in children undergoing cardiac catheterization. This study was designed to determine if elevated serum lidocaine levels could occur after subcutaneous infiltration in children. © 1991.