[Lidocaine: local anaesthetic with systemic toxicity].

In 4 patients, 3 women aged 63, 17 and 43 years, and a man aged 67 years, lidocain was used as a local anaesthetic for a transthoracic esophageal fundoplication (first patient), severe painful gonarthrosis (fourth patient) and legal abortion (second and third patients). All patients suffered from systemic toxicity as a result, a rare complication. They all had an uneventful recovery, except for the second patient who died from adult respiratory distress syndrome after two weeks in the intensive care unit. The second and third patients had inadvertently been given a solution of lidocain that was too strong (10% instead of 1%). The presenting symptoms of systemic toxicity include numbness of the tongue, dizziness, tinnitus, visual disturbances, muscle spasms, convulsions, reduced consciousness, coma, and respiratory arrest. Physicians who use lidocain as a local anaesthetic should be aware of its systemic toxicity.