[Efficacy and side effects of lidocaine by intravenous drip infusion in children with intractable seizures].
Intravenous drip infusions of lidocaine (IDIL; 1-5 mg/kg/h) were performed in ten patients with intractable seizures. The medication was very effective in five patients, whose seizures disappeared immediately after the treatment of IDIL. In four patients, the medication proved to be effective judging from decreased incidence of seizures. In one patient with intractable seizures, the therapy was not effective. In nine patients with the effective medication, five had generalized seizures and four had partial seizures. Side effects were observed in four patients. Two patients had muscle hypotonia, one had visual and auditory hallucination and another had bradycardia. These symptoms completely disappeared after the ceasing of IDIL. Serum concentrations of lidocaine at the appearance of the side effects ranged from 1.8 to 4.7 micrograms/ml, although the toxicity level is more than 5.0 micrograms/ml for arrhythmic adult patients. These findings suggest that the serum toxic level of lidocaine in children is different from that in adults, and that careful observation and appropriate management for the children with lidocaine therapy should be necessary, even though the serum level of lidocaine ranges within the therapeutic level.
Sata
Y
Y
Department of Pediatrics, Yamanashi Medical University.
Aihara
M
M
Hatakeyama
K
K
Hinohara
Y
Y
Kamiya
Y
Y
Shimoda
C
C
Kanemura
H
H
Nakazawa
S
S
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D008297:Male; D008801:Mexiletine / Q000627:therapeutic use; D012640:Seizures / Q000097:blood / Q000188:drug therapy*; D013226:Status Epilepticus / Q000097:blood / Q000188:drug therapy*
D008801:Mexiletine; D008012:Lidocaine