Local anesthetics can have a number of serious side effects, especially if a large amount reaches the systemic circulation.


Neurologic findings:

(1) numbness or tingling of the lips or tongue

(2) metallic taste

(3) feeling of lightheadedness

(4) tinnitus or auditory disturbances

(5) visual disturbance

(6) slurred speech

(7) muscle twitching

(8) disorientation

(9) convulsions

(10) coma

(11) respiratory arrest


Cardiovascular effects:

(1) cardiac arrhythmias

(2) cardiovascular collapse


Other complications:

(1) methemoglobinemia

(2) hypersensitivity reaction

(3) local ischemic necrosis (associated with use of epinephrine as a vasoconstricting agent)

(4) vasovagal or hysterical reaction

(5) thrombosis

(6) bleeding from the injection site

(7) regional neurologic toxicity, especially when used for spinal anesthesia


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