{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:17:03Z","timestamp":1787019423190,"version":"build-2736575974"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Drug Safety"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Local anesthetics have a broad application for minor and major surgeries, in outpatient and inpatient settings. Drug dosing, frequency, duration of action, and coadministration with other drugs, are some of many factors that must be considered for each patient, before drug administration. Like other medical treatments, the use of local anesthetics has potential complications, such as local anesthetic systemic toxicity (LAST). LAST primarily affects the cardiac and central nervous systems (CNS), seizures and cardiac arrest being some of the more time-sensitive symptoms requiring immediate treatment. Patients should be briefed on potential symptoms if LAST occurs and physicians should be aware of the warning signs, treatment, and prevention. In our case study, a 40-year-old, 51\u2009kg woman was administered a lidocaine dosage of 760\u2009mg in an outpatient setting. She presented to the emergency department with diffuse tremors, paresthesias of the mouth and face, spasticity, irritability, and a single generalized tonic\u2013clonic seizure. The patient was successfully treated with Ativan along with lipid emulsion. We review this case and perform a literature review to identify key points in the use of local anesthetics. Healthcare providers should be trained in LAST treatment and prevention. Our case study therefore serves to reduce the frequency of LAST and other adverse outcomes associated with local anesthetic administration.<\/jats:p>","DOI":"10.1177\/20420986251318843","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T02:26:06Z","timestamp":1742264766000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Seizure following in-office lidocaine administration: a case report on local anesthetic systemic toxicity"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5790-8824","authenticated-orcid":false,"given":"Deana","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Erie County Medical Center, Buffalo, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1367-6299","authenticated-orcid":false,"given":"Christopher","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2482-3549","authenticated-orcid":false,"given":"Andre","family":"Rafizadeh","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Erie County Medical Center, Buffalo, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9407-1122","authenticated-orcid":false,"given":"Michael","family":"Nagai","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Erie County Medical Center, Buffalo, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1308\/003588412X13171221502185"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005989"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/head.12246"},{"key":"e_1_3_4_5_2","unstructured":"Iowa Head and Neck Protocols. Maximum recommended doses and duration of local anesthetics https:\/\/medicine.uiowa.edu\/iowaprotocols\/maximum-recommended-doses-and-duration-local-anesthetics (2024 accessed 9 September 2023)."},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.5001\/omj.2019.66"},{"key":"e_1_3_4_7_2","unstructured":"Dosing and Administration: Key dosing considerations with EXPAREL. Pacira Pharmaceuticals Pacira Biosciences Inc. https:\/\/www.exparel.com\/hcp\/about-exparel\/dosing-and-administration#:~:text=Key%20dosing%20considerations%20with%20EXPAREL expanded%20for%20larger%20surgical%20sites (2023 accessed 9 October 2023)."},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15282"},{"issue":"5","key":"e_1_3_4_9_2","article-title":"Lidocaine-induced systemic toxicity: a case report and review of literature","volume":"9","author":"Hasan B","year":"2017","unstructured":"Hasan B, Asif T, Hasan M. Lidocaine-induced systemic toxicity: a case report and review of literature. Cureus 2017; 9(5): e1275.","journal-title":"Cureus"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/1090820X14543102"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-2092(06)62134-0"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.4097\/kja.23031"},{"key":"e_1_3_4_13_2","unstructured":"Garmon EH Huecker MR. Topical local and regional anesthesia and anesthetics. StatPearls http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32773684 (2023 accessed 3 October 2023)."},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.32598\/jpr.10.1.979.1"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/00207450590914617"}],"container-title":["Therapeutic Advances in Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20420986251318843","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20420986251318843","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20420986251318843","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:40:48Z","timestamp":1777592448000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20420986251318843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":14,"alternative-id":["10.1177\/20420986251318843"],"URL":"https:\/\/doi.org\/10.1177\/20420986251318843","relation":{},"ISSN":["2042-0986","2042-0994"],"issn-type":[{"value":"2042-0986","type":"print"},{"value":"2042-0994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]},"article-number":"20420986251318843"}}