Accidental intravascular injection during infiltration anesthesia of the skin.
Accidental intravascular injection of lidocaine during the induction of infiltration anesthesia for dermatologic surgery is an occasional and harmless occurrence. The author noted nine such episodes in a three-year period of full-time private dermatologic practice. A very brief, sharp, stinging pain lasting only seconds and immediately followed by blanching in a vascular distribution characterized these episodes. The blanching, resulting from the 1:200,000 epinephrine solution used in the lidocaine solution usually disappeared within five to ten minutes. Patients experienced no ill effects. The standard textbooks and reviews caution practitioners to aspirate before injecting a local anesthetic; this is unnecessary when performing infiltration anesthesia of the skin.
Epstein
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D000772:Anesthesia, Local / Q000009:adverse effects*; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000009:adverse effects; D012867:Skin / Q000098:blood supply; D012880:Skin Pigmentation / Q000187:drug effects*
D008012:Lidocaine