Lidocaine: A Local Anesthetic, Its Adverse Effects and Management

Bahar, Entaz; Yoon, Hyonok

doi:10.3390/medicina57080782

Cited by 53 publications

(46 citation statements)

References 65 publications

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“…It is important to use local anesthetics according to guidelines ( 35 ). If not used properly, toxic side effects can occur as a result of either an allergic reaction, high systemic exposure due to overdosing or interactions with other pharmacological agents ( 36 ). These toxic effects may lead to serious adverse events such as: confusion, tightness in the chest, loss of consciousness, seizure, respiratory depression, vasodilation or cardiac arrest ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

A novel tDCS control condition using optimized anesthetic gel to block peripheral nerve input

2022

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BackgroundRecent studies indicate that some transcranial direct current stimulation (tDCS) effects may be caused by indirect stimulation of peripheral nerves in the scalp rather than the electric field in the brain. To address this, we developed a novel tDCS control condition in which peripheral input is blocked using topical anesthetics. We developed a compounded anesthetic gel containing benzocaine and lidocaine (BL10) that blocks peripheral input during tDCS.MethodsIn a blinded randomized cross-over study of 18 healthy volunteers (M/F), we compared the gel's efficacy to EMLA and an inert placebo gel. Subjects used a visual analog scale (VAS) to rate the stimulation sensation in the scalp produced by 10 s of 2 mA tDCS every 2 min during 1 h. In an additional in-vitro experiment, the effect of a DC current on gel resistivity and temperature was investigated.ResultsBoth the BL10 and EMLA gel, lowered the stimulation sensations compared to the placebo gel. The BL10 gel showed a tendency to work faster than the EMLA gel with reported sensations for the BL10 gel being lower than for EMLA for the first 30 min. The DC current caused a drastic increase in gel resistivity for the EMLA gel, while it did not affect gel resistivity for the BL10 and placebo gel, nor did it affect gel temperature.ConclusionsTopical anesthetics reduce stimulation sensations by blocking peripheral nerve input during tDCS. The BL10 gel tends to work faster and is more electrically stable than EMLA gel.Clinical trial registrationThe study is registered at ClinicalTrials.gov with name “Understanding the Neural Mechanisms Behind tDCS” and number NCT04577677.

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Section: Discussionmentioning

confidence: 99%

A novel tDCS control condition using optimized anesthetic gel to block peripheral nerve input

2022

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“…Adverse reactions with the use of lidocaine are very rare although some reported effects include allergic reactions, hypotension, AV block, and arrhythmias. 20 Another topical medication that may be used for painful scars is capsaicin. Topical capsaicin works mechanistically by binding to nociceptors in the skin, specifically the TRPV1 receptor.…”

Section: Conservative Treatment Approachesmentioning

confidence: 99%

Diagnosis, Treatment, and Management of Painful Scar: A Narrative Review

Abd‐Elsayed¹,

Pope²,

Mundey³

et al. 2022

JPR

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Painful scars can develop after surgery or trauma, with symptoms ranging from a minor itch to intractable allodynia. The problem of the painful scar may involve both intraneural and extraneural structures, requiring a systematic approach to diagnosis and treatment of this neuropathic pain condition that can impact quality of life and function profoundly. In this review, we outline the algorithm for the diagnosis, management, medical and surgical treatment of painful scars.

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“…Adverse reactions most commonly confused with hypersensitivity reactions include syncope, panic attacks and toxic effects due to inadvertent intravascular drug administration. 20,21 Possible differential diagnoses and their symptoms are listed below.…”

Section: Differential Diagnosis Of Hypersensitivity Reactions To Loca...mentioning

confidence: 99%

“…Excipients such as preservatives (eg benzoates -used in multidose vials) and antioxidants (eg metabisulfites -used in local anesthetics in a solution containing adrenaline) can cause hypersensitivity reactions. 21 Historically, the most sensitizing components in local anesthetic solutions were preservatives such as methylparabens, used in plastic anesthetic tubes to prevent losses due to microbiological contaminants. However, LA used in Dentistry are single-use items, which do not require the inclusion of parabens.…”

Section: Allergy To Other Agentsmentioning

confidence: 99%

Update on local anesthetics hypersensitivity reactions

Marcelino¹,

Felix²,

Ferreira³

et al. 2022

AAAI

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Os anestésicos locais são essenciais em diversos procedimentos médicos e odontológicos. Funcionam estabilizando as membranas neuronais e inibindo a transmissão de impulsos neurais, o que permite a realização desses procedimentos com mais segurança e sem dor. As reações adversas a drogas são definidas pela Organização Mundial da Saúde como todos os efeitos nocivos, não intencionais e indesejáveis de uma medicação, que ocorrem em doses usadas para prevenção, diagnóstico e tratamento. As reações de hipersensibilidade são reações adversas do tipo B, imprevisíveis, que clinicamente se assemelham a reações alérgicas e podem ou não envolver um mecanismo imune. As reações de hipersensibilidade verdadeiras aos anestésicos locais são raras, apesar de superestimadas. Nesta revisão destacamos a necessidade de uma avaliação completa dos pacientes com suspeita de reação alérgica aos anestésicos locais, incluindo a investigação de outros possíveis alérgenos que tenham sido utilizados no procedimento, como analgésicos, antibióticos e látex. A estratégia de investigação e seleção de pacientes para testes deve se basear na história clínica. Dessa forma, poderemos fornecer orientações mais assertivas e seguras aos pacientes.

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Lidocaine: A Local Anesthetic, Its Adverse Effects and Management

Cited by 53 publications

References 65 publications

A novel tDCS control condition using optimized anesthetic gel to block peripheral nerve input

A novel tDCS control condition using optimized anesthetic gel to block peripheral nerve input

Diagnosis, Treatment, and Management of Painful Scar: A Narrative Review

Update on local anesthetics hypersensitivity reactions

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