Current evidence supports use of lipid rescue therapy in local anaesthetic systemic toxicity

2017 ◽  
Vol 61 (4) ◽  
pp. 365-368 ◽  
Author(s):  
G. Weinberg
Keyword(s):  
Local Anaesthetic ◽  
Rescue Therapy ◽  
Systemic Toxicity ◽  
Current Evidence ◽  
Lipid Rescue

Guidelines and the adoption of ‘lipid rescue’ therapy for local anaesthetic toxicity

Anaesthesia ◽  
2009 ◽  
Vol 64 (2) ◽  
pp. 122-125 ◽  
Author(s):  
J. Picard ◽  
S. C. Ward ◽  
R. Zumpe ◽  
T. Meek ◽  
J. Barlow ◽  
...  
Keyword(s):  
Local Anaesthetic ◽  
Rescue Therapy ◽  
Lipid Rescue

Updates in our understanding of local anaesthetic systemic toxicity: a narrative review

Anaesthesia ◽  
2021 ◽  
Vol 76 (S1) ◽  
pp. 27-39
Author(s):  
A. J. R. Macfarlane ◽  
M. Gitman ◽  
K. J. Bornstein ◽  
K. El‐Boghdadly ◽  
G. Weinberg
Keyword(s):  
Local Anaesthetic ◽  
Systemic Toxicity ◽  
Narrative Review

The Effect of Anaesthetic Agents on Platelet Function

1991 ◽  
Vol 19 (4) ◽  
pp. 495-505 ◽  
Author(s):  
N. M. Gibbs
Keyword(s):  
Platelet Aggregation ◽  
Platelet Function ◽  
Local Anaesthetic ◽  
Peak Plasma ◽  
Plasma Concentrations ◽  
Muscle Relaxants ◽  
Current Evidence ◽  
Inhibit Platelet Aggregation ◽  
Anaesthetic Agents ◽  
Thrombotic Complications

This paper reviews studies which have investigated the effect of anaesthetic agents on platelet function The results of these studies suggest that halothane is the only agent in current use which inhibits platelet function in concentrations used clinically. Nitrous oxide appears to cause only a modest inhibition, while enflurane and isoflurane appear to have minimal or negligible effects. There is no current evidence that intravenous induction agents opiates, or muscle relaxants affect platelet function. Reports indicate that local anaesthetic agents inhibit platelet aggregation, but only at concentrations far greater than peak plasma concentrations found during clinical use. Epidural anaesthesia may be associated with a reduction in platelet aggregation through a mechanism unrelated to direct local anaesthetic inhibition. The clinical significance of the effect of halothane on platelet function is not known. However, it is possible that halothane may affect bleeding or thrombotic complications in a similar manner to other ‘anti-platelet’ drugs.

Lipid “Rescue” Therapy

2018 ◽  
pp. 831-834
Author(s):  
Kathryn Benavides ◽  
Jonathan Babyak
Keyword(s):  
Rescue Therapy ◽  
Lipid Rescue

scholarly journals Private Practitioners Knowledge of Local Anaesthetic Systemic Toxicity (LAST)

2021 ◽  
Vol 10 (41) ◽  
pp. 3571-3576
Author(s):  
Neha Yadav ◽  
Reshu Madan Sanan ◽  
Shefali Phogat ◽  
Nisha Yadav ◽  
Nupur Dabas ◽  
...  
Keyword(s):  
Local Anaesthetic ◽  
Anaesthetic Agent ◽  
Nerve Impulse ◽  
Local Anaesthetics ◽  
Systemic Toxicity ◽  
Blood Levels ◽  
Private Practitioners ◽  
Adequate Knowledge ◽  
Online Mode ◽  
Administration Methods

BACKGROUND Local anaesthetics (LAs) by definition are drugs that reversibly block the transmission of a nerve impulse, causing reversible absence of pain sensations without affecting consciousness. As a complication of local anaesthetic administration, a condition called as local anaesthetic systemic toxicity (LAST) can occur which affects central nervous system (CNS) and cardiovascular system (CVS). Local anaesthetic systemic toxicity is a very serious condition that can cause death. In LAST, blood levels of anaesthetic agent exceed the maximum dose, usually as a result of multiple injections or an accidental injection into a vein. The main objective of this survey was to assess the knowledge of LAST among private practitioners and to spread awareness about this common but often neglected complication of local anaesthetic administration. METHODS A survey was conducted with a questionnaire comprising of 15 questions for 251 private practitioners (registered in Indian Dental Association, Gurugram). The survey was mailed to the participants and the response was collected through online mode only. Using Excel program, the results were organized in graphs and tables, and presented as descriptive statistics. RESULTS Of the 251 surveys sent online, 151 were completed, with a survey completion rate of 60 %. On an average, only 39.9 % of the participating dentists had adequate knowledge of local anaesthetic systemic toxicity. Based on the survey, only 3.3 % of participating dentists knew how to use lipid treatment and 55.6 % had no idea about lipid treatment. CONCLUSIONS If LAST occurs, the key is to recognize it immediately and institute appropriate management. Based on the survey, there is a need to create awareness about local anaesthetic systemic toxicity and its management among dentists. KEY WORDS Local Anaesthesia, Last, Complication, Toxicity, Overdose

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