Generalized seizures following topical lidocaine administration during circumcision: establishing causation.
We report a case of neonatal seizures after lidocaine administration for circumcision. A 3-month-old male infant received an overdose as evidenced by toxic lidocaine levels and developed generalized seizures shortly after. Back extrapolation of the serum lidocaine concentration to time zero was used to determine the administered dose. The Naranjo scale was used to determine causation; probable causation was defined. Particular care must be taken to administer an appropriate dose of local anesthetics in infants to avoid life-threatening seizures.
Rezvani
Massoud
M
Division of Clinical Pharmacology - Toxicology and Clinical Biochemistry, The Hospital for Sick Children, Toronto, Ontario, Canada.
Finkelstein
Yaron
Y
Verjee
Zul
Z
Railton
Craig
C
Koren
Gideon
G
D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002944:Circumcision, Male; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D012640:Seizures / Q000139:chemically induced*
D000779:Anesthetics, Local; D008012:Lidocaine