IDIOSYNCRATIC REACTION TO LIGNOCAINE (LIDOCAINE)

Profound depression ofthe automaticity of the sinoatrial and atrioventricular nodes was observed in a 67-year-old man after treatment"with lignocaine. The -man had previously been healthy and was on no medication when he presented with a 24-hour history of episodes of dizziness and lightheadedness. Three hours later he was given a single IV bolus of 50mg lignocaine because of increasingly frequent ventricular contractions. Within 30 seconds he developed sinus bradycardia followed by sinus standstill and junctional escape at a rate of 32 impulses per minute. This was followed by depression of the junctional rhythm with episodes of asystole. Atropine sulphate IV brought a gradual return to sinus rhythm. This was the only time bradycardia was noted in 5 days of monitoring during which quinidine and then procainamide were given orally without recurrence. Manyari-Ortega. D.E. and. Brennan. FJ.: Ch~t 74:,227 (Aug 1978)

INPHARMA 11th November, 1978 p6