Recurrent seizures in a neonate after lidocaine administration.
OBJECTIVE
We report recurrent seizures in a neonate after intravenous lidocaine administration at the recommended dose for intubation and supplementation of general anesthesia.


METHODS
Further evaluation of this case included determination of serum lidocaine level, serum electrolyte levels, and arterial blood gas values; cerebral spinal fluid analysis; an electroencephalogram; head ultrasonography; brain stem auditory evoked response testing; and a complete developmental evaluation. Previously published literature discussing lidocaine toxicity and pharmacokinetics is reviewed.


RESULTS
The lidocaine level in the patient was 0.3 mg/L 2 hours after the last dose was administered. Results of the remaining studies were within normal limits, and the patient had no additional seizures several months after birth.


CONCLUSIONS
We caution that lidocaine administration to newborn infants at previously accepted doses may result in life-threatening side effects, including prolonged seizures.
Resar
L M
LM
Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, Md. 21205, USA.
Helfaer
M A
MA
D000779:Anesthetics, Local / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn / Q000097:blood; D007275:Injections, Intravenous; D007442:Intubation, Intratracheal; D008012:Lidocaine / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D008297:Male; D012008:Recurrence; D012640:Seizures / Q000139:chemically induced*; D014139:Tracheostomy
D000779:Anesthetics, Local; D008012:Lidocaine