What are CNS manifestations of local anesthetic toxicity?

Updated: Jan 09, 2019
  • Author: Raffi Kapitanyan, MD; Chief Editor: David Vearrier, MD, MPH  more...
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Answer

Classically, systemic toxicity begins with symptoms of CNS excitement such as the following:

  • Circumoral and/or tongue numbness

  • Metallic taste

  • Lightheadedness

  • Dizziness

  • Visual and auditory disturbances (difficulty focusing and tinnitus)

  • Disorientation

  • Drowsiness

With higher doses, initial CNS excitation is often followed by a rapid CNS depression, with the following features:

  • Muscle twitching

  • Convulsions

  • Unconsciousness

  • Coma

  • Respiratory depression and arrest

  • Cardiovascular depression and collapse


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