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LETTER TO THE EDITOR

Weakness Following an Overdose of Lidocaine During General Anesthesia

Associate Professor; University of Pittsburgh; kempenpm{at}anes.upmc.edu

To the Editor:

The course of a lidocaine overdose (800 mg = 16 mg/kg) via rapid infusion @ 100 mg/min under general anesthesia, which resulted in BIS readings of zero, profound hypotension (55/30), and supraventricular arrhythmia was recently published (1). The reported hemodynamic compromise was probably contributory in the acute decrease in BIS to zero and the slow, subsequent BIS recovery. No lidocaine blood concentrations were obtained and the patient was described as "weak" after 3 hr of surgery, delaying extubation for an additional hour in PACU. While no specific symptoms/signs representing "clinical weakness" were provided it is possible that the "clinical weakness" described was possibly due to an expected (general) anesthetic effect from the large total lidocaine dose, cerebral ischemia from hypotension, or both (2,3).

REFERENCES

1. Gaughen CM, Durieux M. The effect of too much intravenous lidocaine on bispectral index. Anesth Analg 2006;103:1464–5.[Abstract/Free Full Text]
2. Knight PR, Kroll DA, Nahrwold ML, et al. Comparison of cardiovascular responses to anesthesia and operation when IV lidocaine or morphine sulfate is used as adjunct to diazepam-nitrous oxide anesthesia for cardiac surgery. Anesth Analg 1980;59:130–9.[Abstract/Free Full Text]
3. Denaro CP, Benowitz NL. Poisoning due to class 1B antiarrhythmic drugs. Lignocaine, mexiletine and tocainide. Med Toxicol Adverse Drug Exp 1989;4:412–28.[Web of Science][Medline]

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				C. M. Gaughen and M. E. Durieux The Sedative Effect of High Dose Lidocaine Anesth. Analg., June 1, 2007; 104(6): 1613 - 1614. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Kempen, P. M. Search for Related Content PubMed Articles by Kempen, P. M.