Following publication of advisories, reports of local anesthetic poisoning decreased, but reports of lidocaine poisoning and mortality increased
By Elana Gotkine HealthDay Reporter
FRIDAY, July 25, 2025 (HealthDay News) — Local anesthetic poisoning reports decreased following publication of advisories in 2010, but reports of lidocaine poisoning and mortality have increased, according to a study published online July 21 in Regional Anesthesia & Pain Medicine.
Michael Fettiplace, Ph.D., from the University of Illinois Chicago College of Medicine, and colleagues examined whether reports of local anesthesia-related poisoning and mortality have decreased since the publication of advisories for treating local anesthetic systemic toxicity in 2010. Reports were obtained from the American Poison Centers National Poison Data System. To examine the effect of the 2010 recommendations, a case-noncase disproportionality analysis was conducted using the reporting odds ratio (ROR), comparing reports of poisoning and death from 2011 to 2022 relative to 2001 to 2010.
The researchers found that reports of local anesthesia poisoning decreased in the decade following the introduction of recommendations, relative to the prior decade (ROR, 0.77 for 2011 to 2020 versus 2001 to 2010), driven by a decrease in non-lidocaine-related reports. Conversely, after 2010, reports of lidocaine poisoning and lidocaine mortality increased (ROR, 2.7). There was a decrease noted in reports of death in the operating room, from 47 percent before 2010 to 15 percent after 2010 in a case analysis; an increase was seen in reports of death from intravenous lidocaine delivery (3 to 27 percent).
“These findings highlight the need for enhanced administrative guidance on lidocaine use, greater awareness of the risks of high doses of lidocaine, and improved strategies for preventing and managing severe lidocaine-induced toxicity,” the authors write.
One author disclosed ties to ResQ Pharma.
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