Cardiovascular Complications Resulting from Topical Lidocaine Application

Abstract

Topical lidocaine is one of the most commonly used anesthetics in the emergency department (ED). The advantages of topical anesthesia include ease of application, minimal discomfort on administration, and rapid onset of anesthesia. Systemic toxic effects after topical lidocaine application are rare. We present a case of a man aged 48 years with no history of heart disease and no evidence of bradycardia in previous electrocardiograms. The patient had sprayed lidocaine solution on the glans of his penis before sex during the 2 weeks prior to admission. Cardiovascular adverse events occurred, including chest tightness and bradycardia. After 2 hours conservative treatment at our ED, his symptoms were alleviated. He was discharged from the ED without any medication. The case suggests that detailed patient histories are necessary for accurate diagnosis and that rapid diagnosis and implementation of treatment is necessary for successful patient outcomes in cases of cardiovascular complications resulting from topical lidocaine application.