Poisonings and deaths linked to the common local anesthetic lidocaine have nearly tripled in the United States over the past decade, with fatal overdoses increasingly occurring outside hospitals, where untrained staff administer the supposedly “safe” anesthetic, a new analysis shows.
Over-the-counter topical lidocaine products, which typically contain up to 4 percent to 5 percent lidocaine, are primarily used for temporary relief of pain, itching, and burning sensations. The pain reliever is available in various forms, including creams, ointments, gels, sprays, patches, and foaming soaps. However, in medical settings, it can pose risks that many people may not be aware of.
“Lidocaine is not as safe as we think,” Dr. Michael Fettiplace, study author and assistant professor at the University of Illinois Chicago College of Medicine, told The Epoch Times.
Increase Seen from 2011 to 2022
A recent study, published in Regional Anesthesia & Pain Medicine, reveals a trend hidden within America’s medical system. While overall poisonings from local anesthetics dropped 23 percent after 2010—when medical organizations issued new safety guidelines—lidocaine cases bucked the trend.
Among the risks associated with the drug, lidocaine can cause systemic toxicity when introduced into the bloodstream at high levels. This condition, known as local anesthetic systemic toxicity, primarily affects the central nervous system and cardiovascular system, potentially leading to seizures, arrhythmias, and even cardiac arrest.
Fettiplace’s team had documented increasing toxicity cases in medical literature, but underestimated how often those cases proved fatal. “We identified a rise in mortality events associated with lidocaine, which was unexpected,” he said. “In retrospect, it is not surprising.”
The study analyzed more than 200,000 poisoning cases reported to U.S. poison control centers between 1983 and 2022, including 74 deaths from local anesthetics.
While deaths from other anesthetics declined, the proportion of fatalities linked to lidocaine rose from 67 percent in 2010 to 82 percent in recent years. Overall, 0.1 percent of lidocaine poisoning cases resulted in death, compared with 0.01 percent for other local anesthetics.
In absolute numbers, reports of lidocaine poisoning jumped more than 50 percent, from 1,600 cases in 2016 to 2,500 in 2021.
Many of the deaths occurred after the patient overdosed on lidocaine themselves or received an overdose in outpatient settings.
One case described a 70-year-old man going into cardiac arrest and dying after being administered a 2 percent lidocaine solution. He had undergone an outpatient cardiac magnetic resonance imaging (MRI) scan, and instead of having the MRI dye flushed with normal saline, he was given lidocaine instead.
While poisonings occurred across all age and gender demographics, cases occurred most frequently at home, Fettiplace noted.
The study described one case in which a man inhaled imported lidocaine powder from China to treat his gastroesophageal reflux disease and became unconscious.
“Undoubtedly, there is underreporting,” Fettiplace said. “I cannot predict an upper limit of the increase.”
Hellbound and Down 