Side effects of local anesthetics

Abstract

The Side Effects of Drugs Annual is a yearly review of published literature regarding unexpected effects of drugs. This chapter reviews publications that describe reactions to Local Anesthetics published from January 2021 to December 2021 and early 2022, and covers the following drugs: articaine, benzocaine, benzocaine-lidocaine-tetracaine, bupivacaine, chloroprocaine, cocaine and levamisole, levobupivacaine, lidocaine, lignocaine- triamcinolone, prilocaine-lidocaine, ropivacaine, and tetracaine. Adverse events such as local anesthetic systemic toxicity (LAST) and allergy have been associated with their usage. The following case reports demonstrate additional common themes of methemoglobinemia, neurological deficits, hemodynamic instability, and allergic reactions. Additionally, there have been isolated reports of unique reactions to LAs, such as Delayed Hypersensitivity Reaction and Neuroleptic Malignant Syndrome. In the special studies section, we discuss the adverse reactions that occur with provider error when administering local anesthetics. These cases are specific to errors when utilizing epidural equipment for analgesia. Noting the route and possible adverse effects associated with the use of local anesthetics may decrease unexpected complications.