However, there is some concern with the behavioral effects of lidocaine on offspring in rats.During pregnancy, it is not common for local anesthetics to have any adverse effect on the fetus. Despite this, risks of toxicity may be higher in pregnancy due to an increase in unbound fraction of local anesthetic and physiological changes increase the transfer of local anesthetic into the central nervous system. Hence, it is recommended that pregnant women use a lower dose of local anesthetic to reduce any potential complications. Treatment of overdose: "Lipid rescue"
This method of toxicity treatment was invented by Dr. Guy Weinberg in 1998, and was not widely used until after the first published successful rescue in 2006. Evidence indicates Intralipid, a commonly available intravenous lipid emulsion, can be effective in treating severe cardiotoxicity secondary to local anesthetic overdose, including human case reports of successful use in this way (lipid rescue). However, the evidence at this point is still limited.Though most reports to date have used Intralipid, a commonly available intravenous lipid emulsion, other emulsions, such as Liposyn and Medialipid, have also been shown effective. Ample supporting animal evidence and human case reports show successful use in this way. In the UK, efforts have been made to publicise this use more widely and lipid rescue has now been officially promoted as a treatment by the Association of Anaesthetists of Great Britain and Ireland.
However, leukemoid reactions can resemble more serious conditions such as chronic myelogenous leukemia (CML), which can present with identical findings on the peripheral blood smear. Historically, various clues including the leukocyte alkaline phosphatase score and the presence of basophilia were used to distinguish CML from a leukemoid reaction. However, at present the test of choice in adults to distinguish CML is an assay for the presence of the Philadelphia chromosome, either via cytogenetics and FISH, or via PCR for the BCR/ABL fusion gene. The LAP (leukocyte alkaline phosphatase) score is high in reactive states but is low in CML. In cases where the diagnosis is uncertain, a qualified hematologist or oncologist should be consulted. Treatment
Treatment of underlying condition. If drug induced, discontinue drug. If the reaction is found to be from anything besides drug use, certain anti neoplastic drugs may be indicated. See also
Leukemid
Leukocytosis
Neutrophilia

References


== External links ==