title: Tissue distribution of lidocaine after fatal accidental injection.
abstract: The accidental death of a 64-year-old heart patient as a result of the injection of an incorrect dose of lidocaine is presented. The attending nurse inadvertently administered an intravenous bolus of 10 mL of 20% lidocaine (2g). The patient should have received 5 mL of 2% lidocaine (0.1 g). Such iatrogenic overdoses of lidocaine arise from confusion between prepackaged dosage forms. Lidocaine concentrations (mg/L or mg/kg were: blood, 30; brain, 135; heart, 106; kidney, 204; lung, 89; spleen, 115; skeletal muscle, 20; and adipose, 1.3. The results indicate that even during cardiopulmonary resuscitation as much as 38% of the administered dose of lidocaine may be found in poorly perfused tissue such as skeletal muscle and adipose.
mesh_terms: D000059:Accidents; D005554:Forensic Medicine; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000506:poisoning*; D008297:Male; D008508:Medication Errors; D008875:Middle Aged; D014018:Tissue Distribution
chemical_list: D008012:Lidocaine