Lidocaine reaches the patient by many routes in one admission: infiltration by the surgeon, nerve blocks, airway topicalisation, patches and intravenous infusion. Toxicity depends on the total. Before starting an intravenous infusion, add up what has already been given, dose by ideal or lean body weight, and make sure lipid emulsion and a toxicity protocol are available wherever the infusion runs, including the ward.
- Sum lidocaine from all routes before starting an intravenous infusion.
- Dose by ideal or lean body weight rather than actual weight.
- Ensure lipid emulsion is available where infusions run, not only in theatre.
- Teach ward staff the early signs: perioral numbness, tinnitus, confusion.
Why it matters
Toxicity outside theatre is where rescue is slowest and staff are least prepared.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for anaesthesiology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free