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<p>Lidocaine is frequently employed for local anesthesia in various medical procedures. However, its administration in high-risk populations—including the elderly and individuals with renal dysfunction—can result in adverse effects. The objective of this case series is to document the emergence of neurological manifestations following lidocaine administration in two elderly patients with mild renal impairment undergoing cardiac resynchronization therapy (CRT) implantation. Two elderly patients with mild renal impairment developed acute neurological symptoms after receiving lidocaine for local anesthesia during CRT implantation. The first patient received 600&#xa0;mg, while the second received 800&#xa0;mg. Both exhibited symptoms such as slurred speech, motor impairment, fear, and delirium. Blood pressure remained stable throughout the procedures, ruling out hypotension as a cause. The symptoms resolved spontaneously within 6–8&#xa0;h after discontinuing lidocaine. Neurological and anesthesiology consultations, along with clinical evaluations and laboratory tests, excluded other potential causes, confirming lidocaine toxicity. This case series highlights the importance of cautious lidocaine use, especially in high-risk populations. Strict adherence to dosing guidelines and vigilant monitoring of mental status and vital signs are crucial to prevent and manage lidocaine toxicity during procedures requiring significant local anesthesia.</p>

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Two Cases of Psychiatric Symptoms Induced by Local Anesthesia with Lidocaine during Cardiac Resynchronization Therapy (CRT) Implantation: A Case Series

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年4月28日

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  • Jianfeng Qian,
  • Haixiang Xu,
  • Wen Pan,
  • Jianhua Fan

摘要

Lidocaine is frequently employed for local anesthesia in various medical procedures. However, its administration in high-risk populations—including the elderly and individuals with renal dysfunction—can result in adverse effects. The objective of this case series is to document the emergence of neurological manifestations following lidocaine administration in two elderly patients with mild renal impairment undergoing cardiac resynchronization therapy (CRT) implantation. Two elderly patients with mild renal impairment developed acute neurological symptoms after receiving lidocaine for local anesthesia during CRT implantation. The first patient received 600 mg, while the second received 800 mg. Both exhibited symptoms such as slurred speech, motor impairment, fear, and delirium. Blood pressure remained stable throughout the procedures, ruling out hypotension as a cause. The symptoms resolved spontaneously within 6–8 h after discontinuing lidocaine. Neurological and anesthesiology consultations, along with clinical evaluations and laboratory tests, excluded other potential causes, confirming lidocaine toxicity. This case series highlights the importance of cautious lidocaine use, especially in high-risk populations. Strict adherence to dosing guidelines and vigilant monitoring of mental status and vital signs are crucial to prevent and manage lidocaine toxicity during procedures requiring significant local anesthesia.