Two new studies conducted by researchers at the University of Illinois Chicago found that poisonings from lidocaine have increased over the last 10 years, despite a general decline in poisonings and deaths from the use of local anesthetics.
The studies, published in Regional Anesthesia & Pain Medicine and the British Journal of Anesthesia, analyzed data from reports to national Poison Control Centers and to the FDA between 2010 and 2020. During that time, total reports of poisonings fell 50%, but poisonings from lidocaine specifically increased by more than 50% in less than half of that time — between 2016 and 2020.
The researchers found that fatalities due to lidocaine poisoning were most likely to occur when lidocaine was delivered either by vein or to coat the throat, and always always when given at extremely high doses, sometimes as much as four times the upper limit.
The problem is compounded by the availability of high-dose delivery methods and by the potential for accidental overdose by emergency medical personnel. Enhanced education and updated recommendations may mitigate these risks, according to the authors.