A 34-year-old male presents to the emergency department from his urologist’s office after exhibiting word-finding difficulty and confusion during an elective surgery. He had previously been feeling well and is otherwise healthy. Per discussion with his urologist, the patient reported continued discomfort during the procedure, so he was given additional lidocaine until his pain was sufficiently managed. He developed symptoms that progressed from dizziness to word-finding difficulty and confusion. It was subsequently noticed that he had accidentally been treated with 2% lidocaine without epinephrine instead of 1% lidocaine without epinephrine, thus doubling the intended dose…

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