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Lidocaine in the Treatment of Status Epilepticus
Author(s) -
MD L. Anderson Walkes,
Slovis Corey M.
Publication year - 1997
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.1997.tb03820.x
Subject(s) - lidocaine , medicine , status epilepticus , anesthesia , refractory (planetary science) , placebo , anticonvulsant , epilepsy , physics , alternative medicine , pathology , psychiatry , astrobiology
Intravenous lidocaine has the potential to control seizures. This article reviews the available evidence related to lidocaine's efficacy and clarifies its potential role in the management of status epilepticus (SE). Although there are no large, double‐blind, placebo‐controlled studies of lidocaine's efficacy in SE, numerous case reports and case series support its use. Most of the reported cases involve patients who were refractory to multiple antiseizure medications. Additional support for lidocaine's efficacy in SE comes from the pediatric literature, where lidocaine has been very effective in controlling SE in neonates who have not responded to barbiturates. Initial lidocaine doses used to stop seizures have ranged from 1 to 3 mag. Most reports recommend a maintenance infusion of lidocaine after initial termination of SE, and a continuous infusion is almost universally recommended for neonates. Toxicity from a 1.5–2.0 mgkg dose of lidocaine for the control of SE is rare; the authors found only 1 case of a possible side effect at that dose. The article provides a 5‐step approach to treating SE that includes lidocaine.