Racser Overdosage

Rare cases of clinically significant methaemoglobinaemia have been reported in children. Prilocaine in high doses may cause an increase in the methaemoglobin level. Topical administration of 125 mg prilocaine for 5 hours caused moderate methaemoglobinaemia in a 3-month-old child. Topical administration of 8.6-17.2 mg/kg lidocaine caused very severe intoxication in babies.
Should other symptoms of systemic toxicity occur, the signs are anticipated to be similar in nature to those following the administration of other local anaesthetic treatment, i.e. excitatory CNS symptoms and in severe cases CNS depression and myocardial depression.
Severe neurological symptoms (convulsions, CNS depression) must be treated symptomatically by assisted ventilation and the administration of anticonvulsive drugs. The antidote for methemoglobinemia is methyl thionine. A patient with symptoms of toxicity should be observed for several hours after treatment of these symptoms due to slow systemic absorption.