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HelpTest Code LID Lidocaine, Serum
Specimen Required
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube: Red top (serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial.
Secondary ID
8382Useful For
Assessing optimal lidocaine dosing during the acute management of ventricular arrhythmias following myocardial infarction or during cardiac manipulation such as surgery
Assessing potential lidocaine toxicity
Method Name
Enzyme-Multiplied Immunoassay Technique (EMIT)
Reporting Name
Lidocaine, SSpecimen Type
Serum RedSpecimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days | |
| Ambient | 14 days | ||
| Frozen | 14 days |
Reject Due To
| Gross hemolysis | Reject |
Clinical Information
Lidocaine is commonly used as a local anesthetic, but it is also effective at controlling ventricular arrhythmia and ventricular fibrillation in children and adults. For cardiac therapy, optimal therapeutic response is seen when serum concentrations are between 1.5 and 5.0 mcg/mL. Lidocaine is protein-bound (60-80%), primarily to alpha-1-acid glycoprotein; concentrations of this protein increase after myocardial infarction, which may decrease the amount of free lidocaine and, thus, its efficacy.
Lidocaine undergoes extensive first-pass hepatic metabolism and, therefore, is not administered orally. It is eliminated via renal clearance, with a half-life of approximately 1.5 to 2 hours. Diseases that reduce hepatic or renal function reduce clearance and prolong elimination of lidocaine.
Toxicity occurs when the serum concentration of lidocaine is greater than 6.0 mcg/mL and is usually associated with symptoms of central nervous system excitation, light-headedness, confusion, dizziness, tinnitus, and blurred or double vision. This can be accompanied by bradycardia and hypotension leading to cardiovascular collapse.
Reference Values
Therapeutic: 1.5-5.0 mcg/mL
Critical value: >6.0 mcg/mL
Interpretation
Optimal response to lidocaine occurs when the serum concentration is between 1.5 and 5.0 mcg/mL.
Toxicity is more likely when concentrations exceed 6.0 mcg/mL.
CPT Code Information
80176
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| LID | Lidocaine, S | 3714-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8382 | Lidocaine, S | 3714-3 |
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.