Literature analysis of cardiotoxicity caused by lidocaine

Gulinigeer·Ainiwaer; CHENG Mingxia; XIE Han

doi:10.6039/j.issn.1001-0408.2025.02.13

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Literature analysis of cardiotoxicity caused by lidocaine

更新时间：2025-02-05

- Literature analysis of cardiotoxicity caused by lidocaine
- ZHONGGUO YAOFANG Vol. 36, Issue 2, Pages: 208-213(2025)
- 作者机构：
  
  1.中国药科大学南京鼓楼医院药学部，南京　210008
  2.中国药科大学基础医学与临床药学学院，南京　210009
  3.南京中医药大学鼓楼临床医学院，南京　210009
  4.南京大学医学院附属鼓楼医院药学部，南京　210008
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.02.13
  CLC： R969.3;R971+.2
- Published：30 January 2025，
  
  Received：14 August 2024，
  
  Revised：21 December 2024，
  
  Accepted：2025-01-02
- 稿件说明：
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姑丽尼格尔·艾尼瓦尔 ,程明霞,谢菡.利多卡因致心脏毒性的文献分析 [J].中国药房,2025,36(02):208-213.

Gulinigeer·Ainiwaer ,CHENG Mingxia,XIE Han.Literature analysis of cardiotoxicity caused by lidocaine[J].ZHONGGUO YAOFANG,2025,36(02):208-213.
姑丽尼格尔·艾尼瓦尔 ,程明霞,谢菡.利多卡因致心脏毒性的文献分析 [J].中国药房,2025,36(02):208-213. DOI： 10.6039/j.issn.1001-0408.2025.02.13.

Gulinigeer·Ainiwaer ,CHENG Mingxia,XIE Han.Literature analysis of cardiotoxicity caused by lidocaine[J].ZHONGGUO YAOFANG,2025,36(02):208-213. DOI： 10.6039/j.issn.1001-0408.2025.02.13.

摘要

目的

探讨利多卡因致心脏毒性的临床特征，为临床安全用药提供参考。

方法

以“利多卡因”“心脏毒性”“lidocaine”“cardiotoxicity”等为中英文检索词，检索中国知网、万方数据、维普网、PubMed和Embase，收集利多卡因致心脏毒性相关文献并进行描述性分析。

结果

共纳入31篇文献，共计40例患者。40例患者中，男性23例、女性17例；年龄5个月～73岁，包括≤18岁患者4例、19～59岁17例、≥60岁19例。用药指征以手术麻醉为主（26例），给药途径以静脉给药、神经阻滞麻醉、局部浸润麻醉为主（15、6、6例）；34例患者的用药剂量均符合药品说明书规定；心脏毒性发生时间以用药后1 min～1 h最多（19例），主要症状为心动过缓、心房传导速度减慢、房室传导阻滞、窦性停搏等。34例患者经抢救和对症治疗后好转，6例患者死亡。

结论

利多卡因致心脏毒性可发生在各年龄段，以用药后1 h内为主，主要表现为心律失常、心跳过快或过慢、房室传导阻滞等，且病情严重。临床在使用该药时，应加强对用药剂量、给药途径、毒性反应等的药学监护；出现相关症状时，应及时停药并进行对症治疗，以保障患者的用药安全。

Abstract

OBJECTIVE

To explore the clinical characteristics of cardiotoxicity caused by lidocaine， and provide a reference for the safe use of drug in clinical practice.

METHODS

Chinese and English search terms， such as “lidocaine” “cardiotoxicity”， were used to search for literature related to lidocaine-induced cardiac toxicity from CNKI， Wanfang Data， VIP， PubMed and Embase， and conduct descriptive analysis.

RESULTS

A total of 31 papers were included， with 40 patients. Of the 40 patients， 23 were male and 17 were female； ages ranged from 5 months to 73 years， with 4 patients≤18 years old， 17 patients 19-59 years old， and 19 patients≥60 years old. The main indications for medication were surgical anesthesia （26 cases）， and the main routes of administration were intravenous administration， nerve block anesthesia and local infiltration anesthesia （15， 6， 6 cases）； the dosage of medication for 34 patients complied with the instructions； the most of cardiotoxicity occurred 1 min-1 h after medication （19 cases）， and the main symptoms were bradycardia， atrial conduction slowing， atrioventricular block， sinus arrest， etc. Thirty-four patients improved after resuscitation and symptomatic treatment， and six patients died.

CONCLUSIONS

Lidocaine-induced cardiotoxicity can occur in all ages， mainly within 1 h after administration， and is manifested as arrhythmia， tachycardia or tachycardia， atrioventricular block， etc.， which is severe. When using it clinically， it is necessary to strengthen pharmaceutical monitoring of medication dosage， administration route， toxic reactions， etc.； when relevant symptoms appear， medication should be stopped promptly and symptomatic treatment should be carried out， to protect the safety of drug use.

关键词

利多卡因心脏毒性麻醉药用药安全文献分析

Keywords

cardiotoxicityanestheticsafety of drug useliterature analysis

references

WEIBEL S，JOKINEN J，PACE N L，et al. Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery：a systematic review with trial sequential analysis[J]. Br J Anaesth，2016，116（6）：770-783.

张冰，萨日娜，张晓朦，等. 药源性心脏毒性研究进展[J]. 中国药物警戒，2023，20（8）：841-847.

ZHANG B，SA R N，ZHANG X M，et al. Research pro-gress in pharmacogenic cardiotoxicity[J]. Chin J Pharmacovigil，2023，20（8）：841-847.

何丹，张剑锋. 成功救治利多卡因尿道表面麻醉致心脏骤停1例[J]. 中华灾害救援医学，2014，2（6）：353-354.

HE D，ZHANG J F. Successful treatment of one case of patient with sudden onset of cardiac arrest induced by lidocaine urethral surface anesthesia[J]. Chin J Disaster Med，2014，2（6）：353-354.

刘妙. 2%利多卡因局部麻醉致心跳骤停1例[J]. 中华实用医学，2004，6（12）：90.

LIU M. A case of cardiac arrest due to 2% lidocaine local anesthesia[J]. J Chin Practi Med，2004，6（12）：90.

张天平，杨梓梅，靳国笑，等. 静注利多卡因致Ⅲ°房室传导阻滞、心脏骤停一例[J].中国循环杂志，1988，3（3）：167.

ZHANG T P，YANG Z M，JIN G X，et al. A case of Ⅲ° atrioventricular block and cardiac arrest due to lidocaine injection [J]. Chin Circul J，1988，3（3）：167.

苏贺超. 静注利多卡因致心脏骤停二例报告[J].现代应用药学，1989，6（5）：40.

SU H C. Report of two cases of cardiac arrest due to lidocaine injection[J]. Chin J Mod Appl Pharm，1989，6（5）：40.

李桂清，任毅志. 利多卡因臂丛麻醉致心脏骤停死亡一例[J].中国循环杂志，1993，8（12）：743.

LI G Q，REN Y Z. A case of death from cardiac arrest due to lidocaine brachial plexus anesthesia[J]. Chin Circul J，1993，8（12）：743.

李西. 利多卡因局部麻醉致心跳骤停1例报告[J].岭南急诊医学杂志，2000（4）：212.

LI X. Report of a case of cardiac arrest due to local anesthesia with lidocaine[J]. Lingnan J Emergency Med，2000（4）：212.

雷里加. 利多卡因局部麻醉致心脏骤停死亡1例[J]. 中国医院药学杂志，2009，29（17）：1509-1510.

LEI L J. One case died of cardiac arrest caused by lidocaine local anesthesia[J]. Chin J Hosp Pharm，2009，29（17）：1509-1510.

李峰郁. 利多卡因麻醉致心跳骤停原因分析及护理体会[J]. 河南外科学杂志，2004，10（1）：95-96.

LI F Y. Cause analysis and nursing experience of cardiac arrest caused by lidocaine anesthesia[J]. Henan J Surg，2004，10（1）：95-96.

曾令柏，李燕，肖雪辉，等. 利多卡因球后麻醉致心跳骤停四例[J].中华眼科杂志，1994，30（6）：467.

ZENG L B，LI Y，XIAO X H，et al. Four cases of cardiac arrest due to lidocaine post-bulbar anesthesia[J]. Chin J Ophthalmol，1994，30（6）：467.

熊绪明. 利多卡因治疗眩晕致心脏骤停1例[J]. 医药导报，2000，19（6）：612.

XIONG X M. A case of cardiac arrest caused by lidocaine in the treatment of vertigo[J]. Her Med，2000，19（6）：612.

席连英，田军，熊敏. 利多卡因致窦性停搏1例[J]. 临床荟萃，2003，18（1）：46.

XI L Y，TIAN J，XIONG M. Sinus arrest caused by lidocaine：a case report[J]. Clin Focus，2003，18（1）：46.

师敏，吉鸿斌，张红. 利多卡因致窦性停搏1例报告[J]. 临床荟萃，2004，19（7）：418.

SHI M，JI H B，ZHANG H. Sinus arrest caused by lidocaine：a case report[J]. Clin Focus，2004，19（7）：418.

吴晓华，李仁善，宋伟娜. 利多卡因致房室传导阻滞1例[J].辽宁医学杂志，1991，5（4）：212.

WU X H，LI R S，SONG W N. A case of atrioventricular block caused by lidocaine[J]. Med J Liaoning，1991，5（4）：212.

张晓霞，刘燕燕. 利多卡因致房室传导阻滞1例[J].包头医学院学报，2002，18（2）：155.

ZHANG X X，LIU Y Y. A case of atrioventricular block caused by lidocaine[J]. J Baotou Med Coll，2002，18（2）：155.

张承祥，汪远平，李向. 利多卡因致心跳骤停1例[J]. 现代中西医结合杂志，2000，9（13）：1280.

ZHANG C X，WANG Y P，LI X. A case of cardiac arrest caused by lidocaine [J]. Mod J Integrative Chin Western Med，2000，9（13）：1280.

林海冠，王燕，王建喜. 利多卡因致心脏毒性1例[J]. 总装备部医学学报，2013，15（3）：150，89.

LIN H G，WANG Y，WANG J X. A case of cardiotoxicity caused by lidocaine[J]. Med J GEHQ，2013，15（3）：150，89.

张慧英，姚兴伟，李娟. 利多卡因致心脏骤停[J].中国误诊学杂志，2011，11（32）：8019.

ZHANG H Y，YAO X W，LI J. A case of cardiac arrest caused by lidocaine[J]. Chin J Misdiagn，2011，11（32）：8019.

琚宇太. 利多卡因致心脏骤停1例 [J].安徽医学，1998，19（6）：16.

JU Y T. A case of cardiac arrest caused by lidocaine[J]. Anhui Med Pharm J，1998，19（6）：16.

姚兴伟，李娟. 利多卡因致心脏骤停1例[J]. 中国药事，2002，16（2）：125.

YAO X W，LI J. A case of cardiac arrest caused by lidocaine[J]. Chin Pharm Aff，2002，16（2）：125.

马玉秀. 利多卡因致Ⅲ度房室传导阻滞一例报告[J].吉林医学，1990，11（6）：330.

MA Y X. A case report of third-degree atrioventricular block caused by lidocaine[J]. Jilin Med J，1990，11（6）：330.

毛振邦，罗伟. 利多卡因中毒反应所致心搏骤停抢救成功1例报告[J].江西医药，1981（1）：54-55.

MAO Z B，LUO W. Report of a case of successful resuscitation of cardiac arrest due to toxic reaction to lidocaine[J]. Jiangxi Med J，1981（1）：54-55.

MRAD S，TAWIL C E，SUKAITI W A，et al. Cardiac arrest following liposuction：a case report of lidocaine toxi-city[J]. Oman Med J，2019，34（4）：341-344.

MOUSSA M，CHAKRA M A. Cardiac toxicity after intrau-rethral instillation of lidocaine：a case report and review of literature[J]. Int Braz J Urol，2020，46（2）：302-305.

KLEIN H O，JUTRIN I，KAPLINSKY E. Cerebral and cardiac toxicity of a small dose of lignocaine[J]. Br Heart J，1975，37（7）：775-778.

DIGALA L P，LUCCHESE S. Ⅳ lidocaine infusion lea-ding to the toxic levels in serum causing asystole：a case report[J]. Headache，2020，60（1）：269-270.

TUNNEY R K，Jr，WHYTE K，DEANTONIO H J. Lidocaine toxicity in the setting of HeartMate Ⅱ left ventri-cular assist device[J]. J Clin Pharm Ther，2018，43（5）：733-736.

HASAN B，ASIF T，HASAN M. Lidocaine-induced systemic toxicity：a case report and review of literature[J]. Cureus，2017，9（5）：e1275.

WEBER F，GUHA R，WEINBERG G，et al. Prolonged pulseless electrical activity cardiac arrest after intranasal injection of lidocaine with epinephrine：a case report[J]. A A Pract，2019，12（11）：438-440.

RYAN C A，ROBERTSON M，COE J Y. Seizures due to lidocaine toxicity in a child during cardiac catheterization[J]. Pediatr Cardiol，1993，14（2）：116-118.

KIM J Y，PARK B I，HEO M H，et al. Two cases of late-onset cardiovascular toxicities after a single injection of local anesthetics during supraclavicular brachial plexus block： a report of two cases[J]. Anesth Pain Med，2022，17（2）：228-234.

MITTAL S，MOHAN A，MADAN K R. Ventricular tachycardia and cardiovascular collapse following flexible bronchoscopy：lidocaine cardiotoxicity[J]. J Bronchology Interv Pulmonol，2018，25（2）：e24-e26.

VASQUES F，BEHR A U，WEINBERG G，et al. A review of local anesthetic systemic toxicity cases since publication of the American Society of Regional Anesthesia re-commendations：to whom it may concern[J]. Reg Anesth Pain Med，2015，40（6）：698-705.

GREGORIO G D，NEAL J M，ROSENQUIST R W，et al. Clinical presentation of local anesthetic systemic toxicity：a review of published cases，1979 to 2009[J]. Reg Anesth Pain Med，2010，35（2）：181-187.

FOO I，MACFARLANE A J R，SRIVASTAVA D，et al. The use of intravenous lidocaine for postoperative pain and recovery：international consensus statement on ef-ficacy and safety[J]. Anaesthesia，2021，76（2）：238-250.

CHOU R，GORDON D B，DE LEON-CASASOLA O A，et al. Management of postoperative pain：a clinical practice guideline from the American Pain Society，the American Society of Regional Anesthesia and Pain Medicine，and the American Society of Anesthesiologists Committee on Regional Anesthesia，Executive Committee，and Admi-nistrative Council[J]. J Pain，2016，17（2）：131-157.

LAVONAS E J，AKPUNONU P D，ARENS A M，et al. 2023 American Heart Association focused update on the management of patients with cardiac arrest or life-threatening toxicity due to poisoning：an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care[J]. Circulation，2023，148（16）：e149-e184.

DICKERSON D M，APFELBAUM J L. Local anesthetic systemic toxicity[J]. Aesthet Surg J，2014，34（7）：1111-1119.

MATHER L E，CHANG D H. Cardiotoxicity with modern local anesthetics：is there a safer choice?[J]. Drugs，2001，61（3）：333-342.

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