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Lidocaine for treatment of severe seizures in newborn infants. II. Blood concentrations of lidocaine and metabolites during intravenous infusion

Hellström-Westas, Lena LU ; Svenningsen, N W; Westgren, Ulf LU ; Rosén, Ingmar LU and Lagerström, P O (1992) In Acta Pædiatrica 81(1). p.35-39
Abstract
The blood concentrations of lidocaine and its main active metabolites, methylethylglycinexylidide (MEGX) and glycinexylidide (GX), were measured in 24 newborn infants during anticonvulsive treatment with an iv infusion of lidocaine. After a bolus dose of 1.5-2.2 mg/kg and continuous infusion of lidocaine (4.7-6.3 mg/kg/h) there was accumulation of the drug and MEGX within 24 h. After termination of the iv infusion, both lidocaine and the metabolites were eliminated within 24-48 h. The anticonvulsive effectiveness--estimated by clinical observation and continuous amplitude integrated EEG monitoring (cerebral function monitor)--was immediate in 15 infants (nine term and six preterm). There was no correlation between blood concentrations of... (More)
The blood concentrations of lidocaine and its main active metabolites, methylethylglycinexylidide (MEGX) and glycinexylidide (GX), were measured in 24 newborn infants during anticonvulsive treatment with an iv infusion of lidocaine. After a bolus dose of 1.5-2.2 mg/kg and continuous infusion of lidocaine (4.7-6.3 mg/kg/h) there was accumulation of the drug and MEGX within 24 h. After termination of the iv infusion, both lidocaine and the metabolites were eliminated within 24-48 h. The anticonvulsive effectiveness--estimated by clinical observation and continuous amplitude integrated EEG monitoring (cerebral function monitor)--was immediate in 15 infants (nine term and six preterm). There was no correlation between blood concentrations of lidocaine and metabolites, and anticonvulsive effect (i.e. good, intermediate or no response). No differences in blood concentrations were found between full-term and preterm babies, or between infants with or without birth asphyxia. In combination with a fast withdrawal of the drug, few adverse reactions were seen with the dosages used, even though blood concentrations were high. Routine measurements of lidocaine concentrations during anticonvulsive treatment in neonates seem to be of little clinical value. For evaluation of the anticonvulsive effect and for early detection of seizure activity during lidocaine withdrawal, continuous EEG monitoring is preferable. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anticonvulsant treatment, lidocaine, neonatal seizures, pharmacokinetics
in
Acta Pædiatrica
volume
81
issue
1
pages
35 - 39
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • pmid:1600301
  • scopus:0026570294
ISSN
1651-2227
DOI
10.1111/j.1651-2227.1992.tb12075.x
language
English
LU publication?
yes
id
87ad5ed4-fc2f-4b6f-856f-5490a24aa3e8 (old id 1106171)
date added to LUP
2008-08-01 16:12:04
date last changed
2017-08-20 04:30:02
@article{87ad5ed4-fc2f-4b6f-856f-5490a24aa3e8,
  abstract     = {The blood concentrations of lidocaine and its main active metabolites, methylethylglycinexylidide (MEGX) and glycinexylidide (GX), were measured in 24 newborn infants during anticonvulsive treatment with an iv infusion of lidocaine. After a bolus dose of 1.5-2.2 mg/kg and continuous infusion of lidocaine (4.7-6.3 mg/kg/h) there was accumulation of the drug and MEGX within 24 h. After termination of the iv infusion, both lidocaine and the metabolites were eliminated within 24-48 h. The anticonvulsive effectiveness--estimated by clinical observation and continuous amplitude integrated EEG monitoring (cerebral function monitor)--was immediate in 15 infants (nine term and six preterm). There was no correlation between blood concentrations of lidocaine and metabolites, and anticonvulsive effect (i.e. good, intermediate or no response). No differences in blood concentrations were found between full-term and preterm babies, or between infants with or without birth asphyxia. In combination with a fast withdrawal of the drug, few adverse reactions were seen with the dosages used, even though blood concentrations were high. Routine measurements of lidocaine concentrations during anticonvulsive treatment in neonates seem to be of little clinical value. For evaluation of the anticonvulsive effect and for early detection of seizure activity during lidocaine withdrawal, continuous EEG monitoring is preferable.},
  author       = {Hellström-Westas, Lena and Svenningsen, N W and Westgren, Ulf and Rosén, Ingmar and Lagerström, P O},
  issn         = {1651-2227},
  keyword      = {Anticonvulsant treatment,lidocaine,neonatal seizures,pharmacokinetics},
  language     = {eng},
  number       = {1},
  pages        = {35--39},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Acta Pædiatrica},
  title        = {Lidocaine for treatment of severe seizures in newborn infants. II. Blood concentrations of lidocaine and metabolites during intravenous infusion},
  url          = {http://dx.doi.org/10.1111/j.1651-2227.1992.tb12075.x},
  volume       = {81},
  year         = {1992},
}