Lee Joo Yong, Kim Hyeon Tae, Won Jeong Moon, Shin Young Duck
Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Korea.
J Pain Res. 2020 Sep 22;13:2329-2332. doi: 10.2147/JPR.S271535. eCollection 2020.
Lidocaine is a cost-effective drug that is widely used for local and regional anesthesia. However, central nervous system (CNS) toxicity can occur when lidocaine is administered above the maximum recommended dose (approximately 4.5 mg/kg) or if lidocaine is injected intravascularly rather than administered locally. Systemic toxicity by lidocaine has been reported in several studies. However, psychotic reactions due to lidocaine have been rarely reported; furthermore, reports of lidocaine-related euphoria are very rare. We report a very rare case of euphoria caused by CNS toxicity that occurred during the local administration of lidocaine at the therapeutic dose. Therefore, anesthesiologists should be aware of the severe side effects of local anesthetics despite administering the appropriate dosage at the appropriate location. Future studies should investigate pharmacokinetics to determine the safety profile of local anesthetics.
利多卡因是一种性价比高的药物，广泛用于局部和区域麻醉。然而，当利多卡因的给药剂量高于最大推荐剂量（约4.5毫克/千克），或者如果利多卡因是血管内注射而非局部给药时，可能会发生中枢神经系统（CNS）毒性。多项研究报道了利多卡因的全身毒性。然而，利多卡因引起的精神反应鲜有报道；此外，与利多卡因相关的欣快感的报道非常罕见。我们报告了一例非常罕见的病例，在以治疗剂量局部应用利多卡因期间，因中枢神经系统毒性导致欣快感。因此，麻醉医生应意识到局部麻醉药的严重副作用，尽管在合适的部位给予了合适的剂量。未来的研究应调查药代动力学，以确定局部麻醉药的安全性。
