Table 3

Summary of adverse effects of lignocaine

System	Adverse effects
Neurologic side effects	Tremor, insomnia or drowsiness, lightheadedness, dysarthria and slurred speech, ataxia, depression, agitation, change in sensorium, a change in personality, nystagmus, hallucinations, memory impairment and emotional lability Very high plasma concentrations can result in seizures (note seizure threshold is lower in the presence of pathophysiological abnormalities such as hypercapnia)
Cardiovascular side effects-infrequent; associated with rapid administration	Sinus slowing, asystole, hypotension and shock. Patients with underlying heart disease are most at risk63 64
Respiratory	Bronchodilation at subtoxic doses; respiratory depression occurs at toxic dose ranges
Other	Methemoglobinemia may occur at doses exceeding 600 mg65