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ORIGINAL ARTICLE
Year : 2012  |  Volume : 28  |  Issue : 2  |  Page : 200-204

Toxicity of topical lidocaine applied to the breasts to reduce discomfort during screening mammography


1 Radiation Oncology, St. Luke's Mountain States Tumor and Medical Research Institute, USA
2 Cancer Data Registry of Idaho, Idaho Hospital Association, St. Luke's Mountain States Tumor and Medical Research Institute, USA
3 Medical Oncology, St. Luke's Mountain States Tumor and Medical Research Institute, USA
4 Medical Imaging, St. Luke's Health System, St. Luke's Mountain States Tumor and Medical Research Institute, USA
5 St. Luke's Idaho Cardiology Associates, St. Luke's Mountain States Tumor and Medical Research Institute, USA

Correspondence Address:
Colleen K Lambertz
100 E. Idaho Street, Boise, ID 83712
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9185.94859

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Background : We measured the effect of 30 milliliters (mL) of 4% lidocaine gel on the breasts and chest wall of healthy women covered for 1 h on plasma concentrations of lidocaine and its principal metabolite, monoethylglycinexylidide (MEGX), electrocardiogram (EKG) results, and adverse events. Materials and Methods: This institutional review board-approved, prospective, open-label study complied with the Health Insurance Portability and Accountability Act (HIPAA). The study evaluated 10 healthy women aged 42-75 years with 30 mL of 4% lidocaine gel on the skin of the breasts and chest wall covered for 1 h. Cardiac and neurological assessments were performed and blood was drawn for lidocaine and MEGX levels at baseline and 1/2, 1, 2, 3, 4, 6, and 8 h after application. EKGs were performed before application and at 3 h. Subjects provided informed written consent. Primary and secondary outcomes were plasma concentrations of lidocaine and MEGX and frequency of adverse events, respectively. Statistical analysis included paired t-tests for EKGs and repeated measures regression for vital signs. Results: No lidocaine was detected in the blood of 9 of 10 subjects. One subject had low plasma concentrations of lidocaine just above the level of detection the first 4 h after application only. No MEGX was detected. Mean decrease in heart rate was likely multifactorial. Conclusion: Thirty mL of 4% lidocaine gel on the breasts and chest wall covered for 1 h in healthy women resulted in plasma concentrations of lidocaine and MEGX well below therapeutic or toxic levels and no clinically significant adverse events.


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