Local anaesthetic systemic toxicity following oral ingestion in a child: Revisiting dibucaine

Dibucaine, a potent and toxic local anaesthetic, although currently withdrawn by the United States Food and Drug Administration for use as a spinal anaesthetic, continues to remain available in many over-the-counter topical formulations. Systemic toxicity following oral ingestion of local anaestheti...

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Bibliographic Details
Main Authors: Raylene Dias, Nandini Dave, Milind S Tullu, Chandrahas T Deshmukh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2017-01-01
Series:Indian Journal of Anaesthesia
Subjects:
Online Access:http://www.ijaweb.org/article.asp?issn=0019-5049;year=2017;volume=61;issue=7;spage=587;epage=589;aulast=Dias
Description
Summary:Dibucaine, a potent and toxic local anaesthetic, although currently withdrawn by the United States Food and Drug Administration for use as a spinal anaesthetic, continues to remain available in many over-the-counter topical formulations. Systemic toxicity following oral ingestion of local anaesthetics is rare. We report a case of accidental ingestion of dibucaine (ear drops) in a 7-year-old child who developed diplopia, giddiness, ventricular premature contractions and a right bundle branch block. We also present a brief discussion on the pharmacologic and toxicity profile of dibucaine, the Naranjo algorithm for assessing causality in case of adverse drug reactions and a review of current guidelines on the management of local anaesthetic systemic toxicity.
ISSN:0019-5049
0976-2817