Post Your Cases > IV lidocaine infusion

Patient was scheduled to have IV lidocaine infusion for chronic pelvic pain. Patient was given 200mgs of lidocaine infusion was commenced. The patient started to feel nauseous and also had myoclonic jerks, tachycardia- 150/min. Patient also felt very agitated, treated with 2 blouses of intralipid and IGV infusion.
Patient heart rate settled to 80/min. Myoclonic jerks also settled.
February 12, 2018 | Unregistered CommenterDr Sadiq Bhayani
Great case, Sadiq. We don't often consider lidocaine in LAST, however, this is a mistake since recent data suggest it is one of the LA most commonly involved in LAST, which as you point out often starts with hypertension and tachycardia. the myoclonus is also typical of LAST prodrome. Very glad the patient did well and responded to the lipid. Note that we're currently writing up a case of PEA cardiac arrest after a healthy patient received only 120 mg lidocaine intranasally. This shows the dramatic range in sensitivities to LA.
February 20, 2018 | Unregistered CommenterGuy