期刊文献+

局部应用利多卡因联合分段光热分解治疗的系统毒性

Systemic toxicity from topically applied lidocaine in conjunction with fractional photothermolysis
下载PDF
导出
摘要 Background: Topical anesthetics, unlike injectable anesthetics, can be applied painlessly and can provide sufficient pain control to maintain patient comfort throughout a variety of laser procedures. Although the use of topical lidocaine is considered relatively safe, instances of cardiotoxic andneurotoxic adverse events have been reported to occur. Observations: A 52-year-old woman underwent fractional photothermolysis for management of severe hypopigmentation and scarring of several years’duration. Shortly after termination of treatment to her face and neck, which required prolonged exposure to a 30%lidocaine gel compound both before and during surgery, she developed clinical signs and symptoms consistent with systemic lidocaine toxicity. The results of laboratory studies confirmed serum lidocaine levels within the toxic range. We postulate that the combination of the high concentration of topical lidocaine required to achieve sufficient anesthesia, together with the laser induced disruption in epidermal barrier function,may have been responsible for this phenomenon. Conclusions: Application of a 30%topical lidocaine gel to a limited area in conjunction with fractional photothermolysis may generate serum lidocaine levels high enough to elicit systemic toxicity. Laser surgeons should be alert to this phenomenon, particularly in patientswith underlying hepatic, endocrine, cardiac, or central nervous system/ psychiatric dysfunction; in patients with a low body mass index; and in patients who are taking medications that may interfere with hepatic lidocaine metabolism. Background: Topical anesthetics, unlike injectable anesthetics, can be applied painlessly and can provide sufficient pain control to maintain patient comfort throughout a variety of laser procedures. Although the use of topical lidocaine is considered relatively safe, instances of cardiotoxic andneurotoxic adverse events have been reported to occur. Observations: A 52-year-old woman underwent fractional photothermolysis for management of severe hypopigmentation and scarring of several years'duration. Shortly after termination of treatment to her face and neck, which required prolonged exposure to a 30%lidocaine gel compound both before and during surgery, she developed clinical signs and symptoms consistent with systemic lidocaine toxicity. The results of laboratory studies confirmed serum lidocaine levels within the toxic range. We postulate that the combination of the high concentration of topical lidocaine required to achieve sufficient anesthesia, together with the laser induced disruption in epidermal barrier function,may have been responsible for this phenomenon. Conclusions: Application of a 30%topical lidocaine gel to a limited area in conjunction with fractional photothermolysis may generate serum lidocaine levels high enough to elicit systemic toxicity. Laser surgeons should be alert to this phenomenon, particularly in patientswith underlying hepatic, endocrine, cardiac, or central nervous system/ psychiatric dysfunction; in patients with a low body mass index; and in patients who are taking medications that may interfere with hepatic lidocaine metabolism.
出处 《世界核心医学期刊文摘(皮肤病学分册)》 2006年第11期42-43,共2页 Digest of the World Core Medical JOurnals:Dermatology
  • 相关文献

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部