Acute auditory and vestibular symptoms associated with heat and transdermal lidocaine. Clin J Pain 2010 Jan;26(1):58-9
Date
12/23/2009Pubmed ID
20026955DOI
10.1097/AJP.0b013e3181b2e84eScopus ID
2-s2.0-74049159610 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
OBJECTIVES: To describe a case of systemic lidocaine toxicity from the simultaneous use of transdermal patches and a heating pad.
METHODS: Case report and discussion.
RESULTS: The focus of this case report are the interesting neuro-otologic signs of central lidocaine toxicity that occurred after a patient fell asleep on a heating pad with his Lidoderm patches in place. Hearing improvement, tinnitus reduction, and severe dizziness and ataxia were present for approximately 48 hours before spontaneous resolution. Based upon his symptoms we estimate an 11-fold increase in plasma concentrations of lidocaine.
DISCUSSION: Transdermal delivery of medication affords ease of application, ability to provide continuous pharmacological therapy, and ability to supply medication to the affected site. Due to the superficial application of these medications, external environmental factors may influence the pharmacokinetics of drug delivery. This case highlights the complications that can arise from the combination of heating pads and transdermal pain therapies.
Author List
Shemirani N, Tang D, Friedland DRMESH terms used to index this publication - Major topics in bold
Administration, CutaneousAged
Anesthetics, Local
Auditory Diseases, Central
Hot Temperature
Humans
Lidocaine
Male
Pain Measurement
Vestibular Diseases
