High Dose Lidocaine Intravenous Side Effects

High dose lidocaine is given intravenously to treat heart arrhythmias. Irregular heart rates that affect the ventricles can be fatal if not immediately corrected. Lidocaine calms the heart cells responsible for creating and maintaining electrical impulses in the heart. This action slows fast heart rates and stops arrhythmias. High dose lidocaine intravenous side effects are many but not common. Some rare adverse reactions have lethal outcomes.

Trouble Breathing

Lidocaine, whether used to stop arrhythmias or to control or treat pain, affects the central nervous system. Symptoms include numbness of the mouth and throat and can cause problems with swallowing and breathing. The National Institutes of Health, or NIH, warns that patients receiving lidocaine require close observation; health care personnel administering lidocaine should do so only when emergency resuscitative equipment is readily available. Trouble breathing can deteriorate into respiratory arrest. The NIH explains that symptoms of nervousness, restlessness, ringing in the ears, blurred vision, tremors and dizziness or drowsiness may be warning signs of central nervous system toxicity. Patients receiving lidocaine should report these symptoms to the provider immediately.

Cardiovascular Collapse

Although physicians use high-dose lidocaine intravenously to treat heart arrhythmias, the patient condition can deteriorate. Billie Ann Wilson, PhD., Margaret Shannon, PhD., and Kelly Shields PharmD., authors of “Pearson Nurse’s Drug Guide 2010,” explain that the heart rate can become so low the blood pressure bottoms out and cardiovascular collapse occurs. Patients with a history of heart-block have an increased risk of this serious complication from intravenous lidocaine. Lidocaine toxicity increases the risk of cardiovascular collapse and arrest. Elderly patients or those with a history of heart failure and liver disease have a greater risk of developing toxicity.

Shivering

The degree of symptoms caused by lidocaine is dose dependent. High dose lidocaine causes systemic peripheral nervous system effects. Shivering occurs in 2 percent of patients, according to the National Institutes of Health. Twitching, altered temperature sensations, tremors and numbness and tingling of the extremities have also been reported by patients receiving high dose lidocaine. These symptoms may be manifested for only a brief period of time. The duration of symptoms, however, does not eliminate the possibility of drug overdose. Neurological symptoms such as shivering and tremor may be the first warning signs of drug toxicity and the patient's symptoms can progress into life-threatening problems very quickly.