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LETTER TO THE EDITOR

Lidocaine Toxicity in Volunteer Subjects Undergoing Awake Fiberoptic Intubation

Department of Anaesthesia; The Norfolk and Norwich University Hospital; Norwich, U.K.; nicholas.woodall{at}nnuh.nhs.uk

To the Editor:

The paper by Martin et al. (1) raises serious concerns. Anesthesiologists acting as subjects on a training course in awake intubation were used to validate a training manikin. Martin et al. failed to set an upper dose limit for topical lidocaine administration and observed side effects indicating lidocaine toxicity.

Death as a result of lidocaine toxicity has occurred in a healthy 19-yr-old college student volunteer after bronchoscopy for research purposes (2). That research protocol also failed to specify an upper dose limit for lidocaine. The safety of volunteers and subjects should be paramount. It is essential to specify an upper dose limit when using toxic drugs for research or when providing this type of training on volunteers.

References

1. Martin KM, Larsen PD, Segal R, Marsland CP. Effective nonanatomical endoscopy training produces clinical airway endoscopy proficiency. Anesth Analg 2004;99:938–44.[Abstract/Free Full Text]
2. State of New York, Department of Health. Case Report on Death of University of Rochester Student Issued. Available at http://www.health.state.ny.us/press/releases/1996/wan.htm. Accessed April 2005.

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