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Side-effects

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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