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KMID : 0388419990080020169
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Konkuk Journal of Medical Sciences
1999 Volume.8 No. 2 p.169 ~ p.174
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The Effect of Midazolam and Propofol on Intravenous Lidocaine Test Dose for Detection of its Systemic Toxicity
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Lim Jeong-Ae
Kim Min-Jung
Choi Young-Kil
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Abstract
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Systemic reactions to lidocaine involve primarily in the central nervous system and the cardiovascular system are life threatening. Therefore, lidocaine test dose is administered to detect CNS and cardiovascular toxicity. Purpose of this study was to observe the effect of midazolam and propofol on intravenous lidocaine test dose. Sixty patients were
divided into 3 groups. Each group of patients was received 2.5 ml of saline, 2.5 mg of midazolam, and 25 mg of propofol combined with 4 mg of lidocaine randomly. Five minutes later, lidocaine 1 mg/kg was injected IV. At 1.5 min before(baseline) and every minute after lidocaine administration for 5 min, each subject was questioned regarding
the presense of five symptoms of systemic lidocaine toxicity. Any new light-headedness, dizziness, tinnitus, perioral numbness or metallic taste within 5 min after lidocaine administration was considered as a positive response. Patient’s sedation scale was graded at the baseline period. Positive response to lidocaine was detected in 18 of 20
patients(90%) of the saline group, 11 of 20 patients(55%) of the midazolam group, and 14 of 20 patients(70%) of the propofol group. All patients of the saline group, 5 patients of the midazolam group, and 13 patients of the propofol group had a sedation score of 1. We conclude that midazolam decrease the reliability of subjective detection of IV
lidocaine.
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KEYWORD
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CNS toxicity of lidocaine, midazolam, propofol
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