The use of local anesthetics for postoperative pain is most often in combination with opioids for epidural analgesia or alone for continuous peripheral nerve block (Pasero, Polomono, Portenoy, & McCaffery, 2011). The doses of local anesthetic used for these methods rarely result in blood concentrations sufficient to cause systemic effects. However, vascular uptake or injection or infusion of local anesthetic directly into the systemic circulation can result in adverse reactions related to high blood levels of local anesthetic, although there are reports of no adverse effects following accidental IV infusion of epidural doses of local anesthetics (Allegri et al., 2009). Central nervous system signs of systemic toxicity include ringing in ears, metallic taste, slow speech, confusion, irritability, twitching, and seizures. Signs of cardiotoxicity include circumoral tingling and numbness, bradycardia, cardiac dysrhythmias, acidosis, and cardiovascular collapse (Pasero, Polomono, Portenoy, & McCaffery, 2011). Patients receiving local anesthetics should be evaluated systematically for these signs, and those who receive continuous peripheral nerve block in the home setting must be given verbal and written instructions that include the signs and symptoms of adverse effects, and what to do if detected (Pasero, Eksterowicz, Primeau, & Crowley, 2007).