Test ID: LID
Lidocaine, Serum
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Assessing optimal dosing during the acute management of ventricular arrhythmias following myocardial infarction or during cardiac manipulation such as surgery
Assessing potential toxicity
Method Name A short description of the method used to perform the test
Immunoassay
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube: Red top
Specimen Volume: 1 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross reject |
| Lipemia | Mild OK; Gross reject |
| Icterus | Mild OK; Gross reject |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days |
| Ambient | 14 days | |
| Frozen | 14 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Lidocaine is commonly used as a local anesthetic, but 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 mcg/mL and 5.0 mcg/mL. Lidocaine is 50% protein-bound, 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 thus is not administered orally. It is eliminated via renal clearance, with a half-life of approximately 1.5 hours. Diseases that reduce hepatic or renal function reduce clearance and prolong elimination of lidocaine.
Toxicity occurs when the concentration of lidocaine is >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 Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Therapeutic concentration: 1.5-5.0 mcg/mL
Toxic concentration: >6.0 mcg/mL
Interpretation Provides information to assist in interpretation of the test results
Optimal response to lidocaine occurs when the serum concentration is between 1.5 mcg/mL to 5.0 mcg/mL.
Toxicity is more likely when concentrations exceed 6.0 mcg/mL.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
No significant cautionary statements
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Valdes R Jr, Jortani SA, Gheorghiade M: Standards of laboratory practice: cardiac drug monitoring. National Academy of Clinical Biochemistry. Clin Chem 1998; 44(5):1096-1109
2. "Lidocaine" In Physician’s Desk Reference. November, 2009
3. Harrison DC: Should lidocaine be administered routinely to all patients after acute myocardial infarction? Circulation 1978;58:581-584
Method Description Describes how the test is performed and provides a method-specific reference
Enzyme-multiplied immunoassay technique (EMIT) performed using an Olympus AU680 analyzer. The EMIT assay is a homogeneous EIA technique used for the analysis of specific compounds in biological fluids. The assay is based on competition between drug in the specimen and drug labeled with the enzyme glucose-6-phosphate dehydrogenase (G6P-DH) for antibody binding sites. Enzyme activity decreases upon binding to the antibody, so the drug concentration in the specimen can be measured in terms of enzyme activity. Active enzyme converts oxidized nicotinamide adenine dinucleotide (NAD) to NADH, resulting in an absorbance change that is measured spectrophotometrically. Endogenous serum G6P-DH does not interfere, because the coenzyme functions only with the bacterial (Leuconostoc mesenteroides) enzyme employed in the assay. (Package insert: EMIT Disopyramide. Syva Company, December 2006)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Sunday; Varies
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
80176
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 8382 | Lidocaine, S | 3714-3 |
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