A review of dosages of the most commonly used local anesthetic drugs in dentistry and the management of a toxic reaction is presented. Clinicians need to be in a position to recognize and successfully manage this potential adverse reaction. Lidocaine is a local anesthetic and generally safe. However, it is possible to develop direct nerve and systemic toxicity with too much lidocaine. Lidocaine toxicity presents with a predictable progression from neurological to cardiovascular manifestations, with early CNS symptoms (perioral numbness, ti. Local anesthetic systemic toxicity (LAST) is a rare complication that can develop within minutes of receiving local anesthetics. It’s a medical emergency that causes nervous system and heart issues. Following several fatal cases of LA toxicity, provoked by lidocaine toxicity in tumescent analgesia for liposuction, notification of the risk was repeated socially, and awareness of the problem became highlighted. Local Anaesthetic Toxicity- sodium channel blockade - arrhythmias and neurotoxicity This article talks about how lidocaine overdose happens, the signs and symptoms of lidocaine toxicity, and what to do if you think you've received or taken too much lidocaine. Gain essential insights into lidocaine toxicity. Understand this adverse reaction, how it manifests, and effective strategies for safety. Sign up today to receive the latest news and updates from UpToDate. © 2026 UpToDate, Inc. and/or its affiliates. All Rights Reserved. For more acute poisoning with a shorter anticipated duration (e.g., local anesthetic systemic toxicity), higher doses may be reasonable for a shorter period (e.g., 500-1,000 ml infused over 30-60 minutes).