Lidocaine toxicity not only depends on the dose of anesthetic used, but also on the speed with which it is administered, vascularity at the site of injection, acidosis and low protein in the body. Drug interactions can also lead to toxicity. Propranolol, cimetidine, phenytoin, clonidine and ciprofloxacin are some of the medications which affect lidocaine level in the body. Patients with liver dysfunction are more susceptible to develop toxic effects of lidocaine because its metabolism occurs in the liver. Impaired liver function fails to metabolize the anesthetic, thereby, gradually increasing its level in the body.
Report published by the American Association of Poison Control Centers' National Poison Data System, in the year 2007 states that, 670 children below 6 years of age were found to be affected by lidocaine exposure. In the same report, it was stated that, out of total lidocaine exposures, 229 cases developed minor effects, 83 developed moderate effects and 16 of them suffered from major toxicity effects. However, no deaths were reported in the study. This brings us to the conclusion that, if, lidocaine toxicity is identified at an early stage, the risk of developing serious toxicity outcomes can be reduced to a large extent.
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