The State of Local Anaesthetic Systemic Toxicity in 2025: The Emergence of Lidocaine as Our Next Challenge

ORCID

Abstract

Local anaesthetics are an integral part of surgical and medical practice, but their systemic uptake can result in local anaesthetic systemic toxicity (LAST). A recent study by Fettiplace and colleagues examined the US Food and Drug administration’s Adverse Events Reporting System between 1968 and 2023. Although the reporting of death from longacting local anaesthetics decreased after the publication of relevant practice advisories, Fettiplace and colleagues also found that deaths from lidocaine remained essentially unchanged. The emergence of lidocaine as the leading reported cause of deaths attributable to LAST was unexpected, and the reasons behind the relatively higher number of deaths from lidocaine-induced LAST are not clear. One of the major limitations to this study is the lack of data on population level local anaesthetic administrations.

Publication Date

2025-01-01

Publication Title

British Journal of Anaesthesia

Volume

135

Issue

4

ISSN

0007-0912

Acceptance Date

2025-07-08

Deposit Date

2025-08-14

Embargo Period

2026-07-31

Keywords

adverse effects, evidence-based practice, lidocaine, local anaesthetic systemic toxicity, local anaesthetics

First Page

854

Last Page

856

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This item is under embargo until 31 July 2026

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