scholarly journals Update on the management of local anesthetic systemic toxicity

2021 ◽  
Author(s):  
Marta Inés Berrío Valencia ◽  
Sebastián Rivera Díaz
Keyword(s):  
Local Anesthetic ◽  
Systemic Toxicity ◽  
Local Anesthetic Systemic Toxicity

scholarly journals Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 67-68
Author(s):  
Abdul Nasser ◽  
Faheem Raja
Keyword(s):  
Case Report ◽  
Cataract Surgery ◽  
Local Anesthetic ◽  
Lipid Emulsion ◽  
Early Recognition ◽  
Systemic Toxicity ◽  
Peribulbar Block ◽  
Local Anesthetic Systemic Toxicity ◽  
Symptoms And Signs

ABSTRACT Cataract surgery is performed routinely under regional orbital blocks including retrobulbar and peribulbar blocks. Several complications have been reported while performing these blocks, the most significant of which is the local anesthetic systemic toxicity (LAST). The symptoms and signs present in a varied spectrum, but every such case requires early recognition and immediate resuscitation to avoid long-term morbidity and even death. Lipid emulsion therapy forms the mainstay of treatment. We present a case of a 49-year-old man who planned to undergo cataract surgery under the peribulbar block, who developed LAST and was successfully treated with 20% lipid emulsion without any adverse sequelae. How to cite this article Nasser A, Raja F. Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report. J Med Acad 2020;3(2):67–68.

Local Anesthetics for Neuraxial and Regional Techniques

2018 ◽  
Author(s):  
Michael J Schontz ◽  
Krystina Geiger
Keyword(s):  
Pain Relief ◽  
Adverse Effects ◽  
Local Anesthetic ◽  
Local Anesthetics ◽  
Lipid Emulsion ◽  
Systemic Toxicity ◽  
Duration Of Action ◽  
Liposomal Bupivacaine ◽  
Provide Pain Relief ◽  
Local Anesthetic Systemic Toxicity

Local anesthetics are used with neuraxial and regional techniques to provide pain relief, most commonly postoperatively. Each agent is a sodium-channel blocker, although each agent differs in onset of action, potency, duration of action, and safety profile. Chemical structure and lipophilicity are the main determinants of these characteristics. The agents may be used alone or in combination with an additive which alters the local anesthetic’s properties . Clinically, local anesthetics provide pain relief in a multimodal approach. This reduces opiate consumption, opiate-related adverse effects, and length of stay. Additional benefits when using neuraxial techniques include decreases in mortality, venous thromboembolism, myocardial infarction, pneumonia, respiratory depression, and duration of ileus. Although there are many adverse effects, the most serious include neurologic and cardiovascular. Seizures and cardiac arrest may result from local anesthetic systemic toxicity when systemic levels are elevated or the patient is predisposed. Dose adjustment, removal, or reversal of the agent may be clinically indicated. Lipid emulsion therapy is a reversal agent which acts as a sequestering vehicle for the local anesthetic. Liposomal bupivacaine, the newest formulation of local anesthetic, may provide an increased duration of action compared with standard formulations, although more evidence is needed. This review contains 5 figures, 5 tables, and 59 references. Keywords: amide, ester, epidural, local anesthetic, local anesthetic systemic toxicity, lipid emulsion therapy, liposomal bupivacaine, peripheral nerve block

Pulmonary Aspiration and Local Anesthetic Systemic Toxicity following Epidural Anesthesia

1995 ◽  
Vol 29 (2) ◽  
pp. 291
Author(s):  
Sung Hee Park ◽  
Seon Eek Hwang ◽  
Hwan Yeong Choi ◽  
Eui Soo Hwang ◽  
Jong Hoon Yeom
Keyword(s):  
Epidural Anesthesia ◽  
Local Anesthetic ◽  
Pulmonary Aspiration ◽  
Systemic Toxicity ◽  
Local Anesthetic Systemic Toxicity

Local Anesthetic Systemic Toxicity (LAST) – a Review and Update

2020 ◽  
Vol 10 (2) ◽  
pp. 218-226
Author(s):  
Sivasenthil Arumugam ◽  
Vanja Contino ◽  
Sree Kolli
Keyword(s):  
Local Anesthetic ◽  
Systemic Toxicity ◽  
Local Anesthetic Systemic Toxicity

Incidence of Local Anesthetic Systemic Toxicity and Postoperative Neurologic Symptoms Associated With 12,668 Ultrasound-Guided Nerve Blocks

2012 ◽  
Vol 37 (5) ◽  
pp. 478-482 ◽  
Author(s):  
Brian Daniel Sites ◽  
Andreas H. Taenzer ◽  
Michael D. Herrick ◽  
Constance Gilloon ◽  
John Antonakakis ◽  
...  
Keyword(s):  
Local Anesthetic ◽  
Systemic Toxicity ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Neurologic Symptoms ◽  
Local Anesthetic Systemic Toxicity

Local Anesthetic Systemic Toxicity: Diagnosis, Prevention, and Management

2018 ◽  
Author(s):  
Alexandra Dubikovsky Golden ◽  
David Dickerson
Keyword(s):  
Local Anesthetic ◽  
Lipid Emulsion ◽  
Outpatient Setting ◽  
Systemic Toxicity ◽  
Tumescent Anesthesia ◽  
Local Anesthetic Systemic Toxicity ◽  
Protective Strategies ◽  
Delays In Diagnosis

Local anesthetic systemic toxicity is a major concern in both the inpatient and the outpatient setting, especially with the current increased use of regional, local, and tumescent anesthesia. Lack of protective strategies, delays in diagnosis, and the inability to provide timely lipid emulsion treatment are among the leading preventable causes to contribute to patients’ harm.

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