ArticleRegional anesthesia and pain medicine2026
The impact of local anesthetic systemic toxicity advisories on reporting to the National Poison Data System (NPDS).
Article in Regional anesthesia and pain medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic Review and Meta-Analysis of Lipid Emulsion for Non-Local Anesthetic Poisoning.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Pooled it
- Article
- Case Report: Lidocaine Toxicity Presenting with Focal Neurologic Findings.Clinical practice and cases in emergency medicine · 2026Article
- Expert perspectives on the requirements for implementing prehospital peripheral nerve blocks: a survey among members of the European Society of Regional Anaesthesia (ESRA).BMC anesthesiology · 2026Article
- Differential recovery of ventricular repolarization and hemodynamics following bupivacaine and ropivacaine intoxication: the impact of lipophilicity on lipid emulsion efficacy.Frontiers in pharmacology · 2026Article
- Contemporary local anaesthetic-associated adverse events and mortality: a pharmacovigilance analysis of a US reporting system.British journal of anaesthesia · 2025Article
- From Pain Control to Early Mobility: The Evolution of Regional Anesthesia in Geriatric Total Hip Arthroplasty.Reports (MDPI) · 2025Review
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionIn 2010, multiple anesthesia societies introduced recommendations for treating local anesthetic systemic toxicity, but the impact of those recommendations is uncertain.
objectiveTo test the hypothesis that reports of local anesthetic-related poisoning and mortality have declined since the publication of advisories in 2010.
methodsWe analyzed reports of local anesthetic poisoning and mortality from the American Poison Centers National Poison Data System (NPDS) spanning 1983-2022. We conducted a case-non-case disproportionality analysis using the reporting odds ratio (ROR) to evaluate the effect of the 2010 recommendations on reports of poisoning and death to the NPDS by comparing reports of poisoning and death from 2011 to 2022 relative to 2001-2010. Multiple linear regression and Poisson regression were used for confirmation, together with exploratory analyses of individual cases of mortality.
resultsIn the decade following the introduction of recommendations (2011-2022), reports of local anesthetic poisoning decreased relative the prior decade (2001-2010, ROR=0.77, 95% CI 0.76 to 0.78, p<0.0001), driven by a decrease in non-lidocaine-related reports. Conversely, reports of lidocaine poisoning and reports of lidocaine mortality increased after 2010 (ROR=2.7 95% CI 1.3 to 5.6, p=0.0094). Case analysis revealed a decrease in reports of death in the operating room from 47% before 2010 to 15% after 2010, but an increase in reports of death from intravenous lidocaine delivery (3% to 27%, respectively). DISCUSSION: The decrease in poisoning reports aligns with the implementation of professional recommendations and advancements, such as ultrasound-guided nerve blocks and lipid emulsion therapy. However, the rise in reports of lidocaine-related deaths-primarily in emergency settings-underscores significant risks. These findings emphasize the need for improved guidance on lidocaine use and dosing strategies to prevent lidocaine-related mortality.
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