@article{ref1,
title="Poisoning associated with inappropriate use of a eutectic mixture of lidocaine and prilocaine before laser-assisted hair removal: about 3 cases",
journal="International journal of legal medicine",
year="2019",
author="Caré, Weniko and Larabi, Islam-Amine and Langrand, Jerome and Médernach, Chantal and Alvarez, Jean-Claude and Villa, Antoine",
volume="133",
number="3",
pages="843-846",
abstract="BACKGROUND: Eutectic mixtures of lidocaine and prilocaine are used during painful dermatological procedures. Poisoning is rarely reported in adults. MATERIAL AND METHOD: We report three cases of women who experienced lidocaine and prilocaine poisoning after laser-assisted hair removal. Plasma levels of local anesthetics were assayed by a fully validated liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) method. CASE REPORTS: The rules of application of the anesthetic cream were observed apart from the maximum dose and/or maximum surface area. One patient applied a higher dose than the maximum recommended dose (140 instead of 60 g) and all patients failed to comply with the maximum recommended surface area (600 cm<sup>2</sup>). The patients presented an unusual clinical pattern as compared with other local anesthetics overdose: signs of cardiac toxicity with no ECG changes or arrhythmia, neurological toxicity without seizures or coma, and methemoglobinemia. <br><br>DISCUSSION: Health authorities should publish explicit recommendations targeting users and prescribers with particular emphasis on the maximal surface area of application.<p /> <p>Language: en</p>",
language="en",
issn="0937-9827",
doi="10.1007/s00414-018-1858-9",
url="http://dx.doi.org/10.1007/s00414-018-1858-9"
}