Death from ARDS and Cardiovascular Collapse following Lidocaine Administration

Promisloff, Robert; Dupont, D

doi:10.1378/chest.83.3.585a

Cited by 29 publications

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“…Many oxidant substances, including anesthetic agents, can accelerate the formation and dangerously increase the circulating fraction of methemoglobin, which is normally less than 2% of total hemoglobin. 13,14 A similar case of lidocaine-induced adult respiratory distress syndrome (ARDS) was described after subcutaneous administration of lidocaine for suturing a wound. The severity of symptoms and consequences depends on the methemoglobin level, ranging from central cyanosis (>15% of total hemoglobin) to neurologic and cardiac dysfunction (>45%) to death (>70%).…”

Section: Discussionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome After Airway Anesthesia With Lidocaine

Dʼelia¹,

Ghio²

2010

Journal of Bronchology &Amp; Interventional Pulmonology

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Adequate anesthesia of the upper and proximal lower airways is a critical prerequisite for a smooth and successful bronchoscopic procedure. Lidocaine is the most commonly used local anesthetic agent for flexible bronchoscopy. Adverse reactions to this agent have rarely been reported. Nevertheless, we recently observed a life-threatening reaction to airway lidocaine anesthesia in a 33-year-old man who was to undergo flexible bronchoscopy for the evaluation of an intrathoracic lymphadenopathy. Before the procedure, the patient developed noncardiogenic pulmonary edema. Only 2 such cases after airway anesthesia with nontoxic doses of lidocaine for a bronchoscopic procedure have been reported in the literature. Unlike in these cases, the episode was brief and self-limiting, with adverse reaction confined to the respiratory tract without development of shock or systemic involvement.

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Section: Discussionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome After Airway Anesthesia With Lidocaine

Dʼelia¹,

Ghio²

2010

Journal of Bronchology &Amp; Interventional Pulmonology

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“…Proven allergy to amide local anaesthetics is occasionally encountered, involving prilocaine, mepivacaine, lignocaine and bupivacaine (Brown, Beamish and Wildsmith, 1981;Fisher and Pennington, 1982;Yeoman, 1982), while cross-reactivity within the group is by no means universal (de Shazo and Nelson, 1979;Fisher and Pennington, 1982). The majority of cases involve dental blocks, although lignocaine given by many routes has been implicated in respiratory distress syndrome (Howard, Mohsenifar and Simon, 1982;Promisloff and DuPont, 1983;Woelke and Tucker, 1983;Rooke and Milne, 1984). I have found no record of a verified allergic reaction to extradural bupivacaine.…”

Section: Allergic Reactionsmentioning

confidence: 98%

Adverse Effects of Local Anaesthetics

Reynolds¹

1987

British Journal of Anaesthesia

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Complications of local anaesthesia in general have been considered in so far as they may be confused with adverse effects of local anaesthetic drugs. Local anaesthetics may give rise to adverse reactions by a number of mechanisms. They affect nerve conduction and vasculature at the site of injection: a local effect; but is it unlikely that they ever produce an irreversible noxious effect on nerve fibres. They produce regional effects resulting from nerve conduction blockade; hypotension and respiratory depression by this mechanism are frequently mistaken for pharmacological effects of the agent concerned. They produce focal effects, usually when carried in high concentration via the arterial supply to the brain. They produce systemic effects following absorption or intravenous administration, which are manifested principally in the central nervous system. Ignorance or carelessness are frequently causative factors in serious reactions. Adequate oxygenation is vital in prophylaxis and immediate treatment of systemic toxicity, while resuscitative skill and equipment must always be to hand. Idiosyncrasy or allergy can only rarely be an excuse for adverse reactions to local anaesthesia.

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“…In addition, in the setting of ARDS and lidocaine administration, cardiovascular collapse has occurred. [15] Ropivacaine, with its improved safety profile when compared with other local anesthetics,[16] may prove to be a safer option in critically ill-patients, especially with its in-vivo benefits when administered IT,[11] further limiting systemic toxicity.…”

Section: Evidence From the Benchmentioning

confidence: 99%

Bench-to-bedside: The use of local anesthetics to attenuate inflammation in acute respiratory distress syndrome

Krishnamoorthy

Chung

2014

Int J Crit Illn Inj Sci

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The acute respiratory distress syndrome (ARDS) remains a world-wide treatment challenge, with high morbidity and mortality. The central pathophysiology of ARDS centers around inflammation in the lung and increased microvascular permeability. Local anesthetics have been shown to have anti-inflammatory effects at the basic science level and the advent of local anesthetics with improved cardiovascular safety profiles has made use of local anesthetics in attenuating the inflammation in ARDS a recent research interest. In this review, we will provide a brief summary of some of the basic science work in local anesthetics and lung inflammation and provide a case for the bench to bedside research in this potential therapy.

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Death from ARDS and Cardiovascular Collapse following Lidocaine Administration

Cited by 29 publications

References 0 publications

Acute Respiratory Distress Syndrome After Airway Anesthesia With Lidocaine

Acute Respiratory Distress Syndrome After Airway Anesthesia With Lidocaine

Adverse Effects of Local Anaesthetics

Bench-to-bedside: The use of local anesthetics to attenuate inflammation in acute respiratory distress syndrome

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