TY - CHAP M1 - Book, Section TI - Local Anesthetics A1 - Wasson, Cassandra A1 - Peterson, Stacy A2 - Ellinas, Herodotos A2 - Matthes, Kai A2 - Alrayashi, Walid A2 - Bilge, Aykut PY - 2021 T2 - Clinical Pediatric Anesthesiology AB - FOCUS POINTSIn infants, amide local anesthetics are not metabolized at a regular rate. This is especially important to remember when running infusions either intravenously or via regional or neuraxial anesthesia.Ester local anesthetics are metabolized by pseudocholinesterases in the plasma. Amide local anesthetics are metabolized in P450 dependent pathways.Maximum dose of local anesthetic varies based on the local anesthetics and sometimes the addition of epinephrine.Treatment of local anesthetic systemic toxicity has two arms—one is supportive care and another is treatment with intralipid 20% at 1.5 mL/Kg.Systemic absorption depends on location of injection, with intercostal injection leading to the highest blood levels. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1176457222 ER -