A nurse is preparing a patient to go home from the emergency department after receiving sutures for a laceration on one hand. The provider used lidocaine with epinephrine as a local anesthetic. Which symptom in this patient causes the most concern?

Question

a. Difficulty moving the fingers of the af-fected hand
b. Inability to feel pressure at the suture site
c. Nervousness and tachycardia
d. Sensation of pain returning to the wound

Answer 1

C
Absorption of the vasoconstrictor can cause systemic effects, including nervousness and tachy-cardia. If severe, alpha- and beta-adrenergic antagonists can be given. Local anesthetics are non-selective modifiers of neuronal function and also can block motor neurons, so it is expected that patients may have difficulty with movement. The sensation of pressure also is affected and is an expected effect. As the local anesthetic wears off, the sensation of pain will return.