Dias Raylene, Dave Nandini, Tullu Milind S, Deshmukh Chandrahas T
Department of Anaesthesiology, Seth G.S. Medical College, KEM Hospital, Mumbai, Maharashtra, India.
Department of Paediatric Intensive Care, Seth G.S. Medical College, KEM Hospital, Mumbai, Maharashtra, India.
Indian J Anaesth. 2017 Jul;61(7):587-589. doi: 10.4103/ija.IJA_166_17.
Dibucaine, a potent and toxic local anaesthetic, although currently withdrawn by the United States Food and Drug Administration for use as a spinal anaesthetic, continues to remain available in many over-the-counter topical formulations. Systemic toxicity following oral ingestion of local anaesthetics is rare. We report a case of accidental ingestion of dibucaine (ear drops) in a 7-year-old child who developed diplopia, giddiness, ventricular premature contractions and a right bundle branch block. We also present a brief discussion on the pharmacologic and toxicity profile of dibucaine, the Naranjo algorithm for assessing causality in case of adverse drug reactions and a review of current guidelines on the management of local anaesthetic systemic toxicity.
丁卡因是一种强效且有毒的局部麻醉剂，尽管目前已被美国食品药品监督管理局撤出用于脊髓麻醉，但在许多非处方局部用制剂中仍可获得。口服局部麻醉剂后的全身毒性很罕见。我们报告一例7岁儿童意外摄入丁卡因（滴耳液）的病例，该患儿出现了复视、头晕、室性早搏和右束支传导阻滞。我们还简要讨论了丁卡因的药理和毒性概况、用于评估药物不良反应因果关系的纳兰霍算法以及当前局部麻醉剂全身毒性管理指南的综述。
