side-effects
Last reviewed 01/2018
Toxicity from local anaesthetics may result if they are excessively or repeatedly administered, or injected into a vein. Neonates are particularly at risk because the elimination half-life of these drugs is 2-3 times that in adults. Conversely, blood levels for monitoring are difficult to interpret.
Some practical safety measures include:
- aspirating at all injections to determine the site
- watching carefully for signs of toxicity:
- sedation or excitability
- myocardial depression or ventricular fibrillation
- using bupivacaine and lignocaine - the most widely used drugs in this situation
- avoiding mixing local anaesthetics with adrenaline, especially near end arteries, e.g. for penile block during circumcision