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Anaesthesia
Cardiac or central nervous system toxicity may result when standard lidocaine doses are administered to patients with circulatory failure. This may be due to the following reason –
Lidocaine concentration are initially higher in relatively well perfused tissues such as brain and heart
Histamine receptors in brain and heart gets suddenly activated in circulatroy failure
There is a sudden out-burst of release of adreneline, noradreneline and dopamine in brain and heart
Lidocaine is converted into a toxic metabolite due to its longer stay in liver
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