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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The authors have reflected on all the points highlighted by McAllister et al&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Regarding low body weight being one of the key risk factors for complications of local anesthetics &#40;LA&#41;&#44; we agree&#44; as we clearly stated in the discussion section of our case report<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> &#8211; &#8220;The most critical aspect of LA is appropriate dosing&#46; The lowest effective dose should be used and patient weight and comorbidities need to be considered when calculating the dose&#46;&#8221; The risks of LA are well known within anesthesiologists&#8217; clinical practice&#44; and we are aware of the need to identify high-risk patients&#44; as LA are commonly used in our practice in a variety of routes of administration&#46; This topic is frequently covered in anesthesiology journals&#44; especially by regional anesthesia societies&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">3&#8211;5</span></a> However&#44; these journals are not usually of interest to other medical and surgical specialties and we consider that local anesthetic systemic toxicity &#40;LAST&#41; is potentially overlooked by other practitioners&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Our main aim in publishing this case report was to raise awareness of the risks of administering lidocaine&#44; a commonly used drug in all medical and surgical specialties&#44; in which physicians may not be as aware of the risk factors and the possibility of LAST&#46; Lidocaine is widely used and is frequently considered to be extremely safe&#59; however&#44; many practitioners may fail to identify high-risk patients and may misdiagnose the early symptoms of LAST&#46; This is what occurred in the case presented&#58; the first suspected diagnosis was anaphylaxis&#44; as LAST is rarely in the minds of those who frequently use local anesthetics&#46; We presented the case especially because the subcutaneous route was used&#44; a frequent practice in outpatient settings&#44; as it is commonly considered an innocuous route of administration&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Overall&#44; we are in line with McAllister et al&#46;&#8217;s reflections and completely agree with their conclusion that prevention is key&#44; by considering weight&#44; route of administration and comorbidities in order to identify high-risk patients&#46; However&#44; we are also aware that choosing the correct dosage when performing outpatient procedures on such high-risk patients is challenging for medical practitioners&#46; Thus&#44; we would like to highlight the need to refer these patients to the care of an anesthesiologist&#44; so that other possibilities beyond local anesthetic infiltration can be weighed to ensure a safe&#44; effective and comfortable procedure for both patient and practitioner&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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