title: Elevated lidocaine serum concentration after subcutaneous lidocaine administration using a needle-free device in pediatric patients.
abstract: We report several cases in which pediatric patients at our institution have elevated lidocaine levels in toxicology screens after subcutaneous injection of lidocaine using a needle-free device. The purpose of this article is to report 4 cases in which pediatric patients have elevated lidocaine levels in toxicology screens after J-Tip administration. In particular, the article highlights 2 cases in which children younger than 3 years had lidocaine levels in the toxic range. Although the literature has reported the device to be effective with no significant untoward effects in children as young as 3 years, it seems that no information is available for children younger than 3 years. From a quality assurance/safety perspective, a summary is provided as our institutional response to concerns raised over what is typically thought to be a benign and beneficial intervention in children.
authors.affiliation: From the *Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital; †Harvard Medical School; and Departments of ‡Emergency Medicine, and §Pediatrics, Massachusetts General Hospital, Boston, MA.
authors.forename: Padma
authors.initials: P
authors.lastname: Gulur
authors.forename: Ari R
authors.initials: AR
authors.lastname: Cohen
authors.forename: Lisa
authors.initials: L
authors.lastname: Watt
authors.forename: Mary E
authors.initials: ME
authors.lastname: Lau
authors.forename: Chadi
authors.initials: C
authors.lastname: El Saleeby
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000097:blood*; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D007279:Injections, Subcutaneous / Q000295:instrumentation; D008012:Lidocaine / Q000008:administration & dosage* / Q000097:blood*; D008297:Male; D009339:Needles
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine