Dosing
Max Dose: Local Anesthetic Dosing Calculator
General Adult: 40 mL 1% lidocaine
Allergy / Toxicity
Allergy
If the patient does have some other mild allergic reaction such as swelling or pruritic rash, local administration of an anesthetic within the other group is considered safe.
Toxicity
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Local anesthetic toxicity results from sodium channel blockade, which affects the central nervous system and cardiac system. The CNS is more sensitive to the effects of local anesthetics than the cardiac system and will generally manifest signs/symptoms of toxicity first.
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The presenting symptoms of LAST include perioral numbness, metallic taste, mental status changes or anxiety, visual changes, muscle twitching, and ultimately, seizures, coma, and respiratory depression. Cardiovascular effects include tachycardia, hypertension, ventricular arrhythmias and/or asystole.