Cardiac arrest after intraurethral administration of lidocaine.
We report a case of cardiac arrest immediately following intraurethral administration of lidocaine as topical anesthesia for cystourethroscopy in an 87-year-old man. Intraurethral mucosa lesions from previous attempts at Foley catheter insertion led to a rapid elevation in the blood concentration of lidocaine. In the presence of such factors as a urethral obstruction and a high lidocaine concentration, signs of cardiovascular toxicity can occur almost simultaneously with those of central nervous system toxicity. We, therefore, recommend that spinal or general anesthesia may be better for patients with intraurethral mucosa lesions undergoing urethral procedures.
Chang
Ya-Ying
YY
Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan.
Ho
Chiu-Ming
CM
Tsai
Shen-Kou
SK
D000368:Aged; D000779:Anesthetics, Local / Q000009:adverse effects*; D006323:Heart Arrest / Q000139:chemically induced*; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects*; D008297:Male
D000779:Anesthetics, Local; D008012:Lidocaine