From the Guidelines
Lidocaine injections can cause nausea as a side effect, as reported in 3 patients out of 544 in a large series, highlighting the need for careful dosing and administration. Lidocaine is a local anesthetic commonly used to numb specific areas of the body during medical procedures or to treat pain. While most people tolerate lidocaine well, some individuals may experience nausea after receiving injections, particularly if the medication enters the bloodstream too quickly or in higher amounts than intended 1. This side effect is more common with higher doses or when lidocaine is used in certain sensitive areas. Nausea typically occurs shortly after administration and is usually temporary. Other potential side effects that might accompany nausea include:
- Dizziness
- Lightheadedness
- Peri-oral numbness
- Tinnitus
- Bradycardia If you experience persistent or severe nausea following a lidocaine injection, you should contact your healthcare provider. To minimize the risk of nausea, healthcare providers typically use the lowest effective dose and may inject the medication slowly, taking into account the patient’s weight and co-morbidities 1. Patients should always inform their healthcare providers about any previous adverse reactions to local anesthetics. The risk-benefit decision to use lidocaine needs to reflect the type of surgery and the patient’s condition, emphasizing the importance of careful consideration and monitoring 1.
From the FDA Drug Label
In a prospective review of 10,440 patients who received lidocaine HCl for spinal anesthesia, the incidences of adverse reactions were reported to be ... less than 1 percent each for ... nausea
Systemic Adverse experiences following the administration of lidocaine HCl are similar in nature to those observed with other amide local anesthetic agents ... may result from a hypersensitivity, idiosyncrasy or diminished tolerance on the part of the patient.
Central Nervous System CNS manifestations are excitatory and/or depressant and may be characterized by ... vomiting,
Lidocaine injection can cause nausea. The incidence of nausea is reported to be less than 1 percent in patients who received lidocaine HCl for spinal anesthesia 2.
From the Research
Lidocaine Injections and Nausea
- Lidocaine injections can cause nausea, as evidenced by several studies 3, 4, 5.
- A study published in 2013 found that reducing the dose of lidocaine decreased the incidence of nausea and vomiting in patients undergoing spinal anesthesia for caesarian section 3.
- Another study from 1998 discovered that swallowing topically administered 4% lidocaine resulted in a significant increase in the incidence of nausea and vomiting 4.
- However, some studies suggest that lidocaine can also be used to reduce post-operative nausea and vomiting (PONV) when administered intravenously 6, 7.
- A 2021 study found that 1.8% of patients experienced vasovagal responses, including nausea, after being injected with lidocaine and epinephrine for minor procedures 5.
Mechanisms and Incidence
- The exact mechanisms by which lidocaine causes nausea are not fully understood, but it is thought to be related to higher blood levels or a direct toxic effect 4.
- The incidence of nausea and vomiting after lidocaine injection can vary depending on the dose, route of administration, and individual patient factors 3, 4, 5.
- Some studies suggest that the incidence of PONV can be reduced by using lidocaine as part of a multimodal analgesia regimen or by administering it intravenously 6, 7.