Side effects of lidocaine in outpatient pediatrics

Abstract

Lidocaine poisoning with parenteral administration, accompanied by systemic toxic effects, is quite rare in pediatric practice, but even single cases may cause the development of critical conditions that require treatment in the intensive care unit. Objective. To demonstrate a clinical case of severe lidocaine poisoning in two children and the main measures to stabilize the condition of patients with overdoses of local anesthetics. The article presents the basic historical data on the creation of lidocaine, its pharmacokinetics and pharmacodynamics in children. The maximum single dose was indicated based on the patient's weight. The main principles of intensive therapy for lidocaine poisoning in children were considered, and the algorithm of actions in the development of a life-threatening state was provided. Special attention was paid to the use of the «lipid rescue protocol» in hemodynamic disorders and cardiac arrest. Conclusion. When prescribing local anesthetics in children, one should take into account the anatomical and physiological characteristics of the child, the age characteristics of the pharmacological effects of the drugs, and the maximum permissible single dose, which will prevent the occurrence of iatrogenic life-threatening complications. Key words: lidocaine, poisoning, systemic toxic effects, intensive care, pediatric