Unusual presentation of local anesthetic toxicity.
The local anesthetic systemic toxicity can be due to increased blood lignocaine levels or due to increased sensitivity to lignocaine. Several cases of lignocaine-induced central nervous system toxicity have been noted, but none have reported only loss of consciousness without any seizure-like activity. Intravenous lipid emulsion administration for the treatment of local anesthetic systemic toxicity is an emerging topic of discussion, and there are case reports where they had successfully been used. However, majority of them were used in the treatment of cardiovascular manifestations of local anesthetic toxicity. We report a case of a 19-year-old man who had unconsciousness on 2 separate occasions after local lignocaine infiltration to undergo surgery for dental malocclusion and the use of lipid emulsion in its management.
Department of Anaesthesiology, Lady Hardinge Medical College, New Delhi, India. Electronic address: nitin.hayaran@rediffmail.com.
Nitin
N
Hayaran
Department of Anaesthesiology, Lady Hardinge Medical College, New Delhi, India. Electronic address: rashidoc.18@gmail.com.
Rashi
R
Sardana
Department of Anaesthesiology, Lady Hardinge Medical College, New Delhi, India.
Hamse
H
Nandinie
Department of Anaesthesiology, Lady Hardinge Medical College, New Delhi, India.
Aruna
A
Jain
D000779:Anesthetics, Local / Q000009:adverse effects*; D004655:Emulsions / Q000627:therapeutic use; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects*; D008297:Male; D008310:Malocclusion / Q000601:surgery; D010743:Phospholipids / Q000627:therapeutic use; D011183:Postoperative Complications / Q000628:therapy; D013024:Soybean Oil / Q000627:therapeutic use; D014474:Unconsciousness / Q000139:chemically induced* / Q000628:therapy; D055815:Young Adult
D000779:Anesthetics, Local; D004655:Emulsions; D010743:Phospholipids; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil; D008012:Lidocaine
Intralipid; Local anesthetic; Toxicity