Open AccessLocal anaesthetic systemic toxicity following oral ingestion in a child: Revisiting dibucaine
Author(s) -
Raylene Dias,
Nandini Dave,
Milind S. Tullu,
C T Deshmukh
Publication year - 2017
Publication title -
indian journal of anaesthesia/indian journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.645
H-Index - 30
eISSN - 0976-2817
pISSN - 0019-5049
DOI - 10.4103/ija.ija_166_17
Subject(s) - medicine , dibucaine , ingestion , anesthesia , toxicity , adverse effect , pharmacology , intensive care medicine , chemistry
Dibucaine, a potent and toxic local anaesthetic, although currently withdrawn by the United States Food and Drug Administration for use as a spinal anaesthetic, continues to remain available in many over-the-counter topical formulations.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.