TY - CHAP M1 - Book, Section TI - Local Anesthetic Systemic Toxicity A1 - Li, Yunping A2 - Hess, Philip E. A2 - Li, Yunping A2 - Kowalczyk, John J. A2 - Stiles, Justin K. Y1 - 2023 N1 - T2 - Obstetric Anesthesia: Quick References & Practical Guides AB - Incidence of local anesthetic systemic toxicity (LAST) after peripheral nerve blocks is higher than after epidural anesthesia.Ultrasound-guided peripheral nerve block is associated with lower incidence of LAST (Odds ratio 0.23).1Use of epinephrine in local anesthetics decreases its systemic absorption.In 1998, Dr. Guy Weinberg first observed that pretreatment or resuscitation with a lipid infusion shifts the dose-response curve to the right in a rat model of bupivacaine-induced asystole.2In 2006, the first case was reported of the successful use of a 20% lipid emulsion (intralipid) in a patient after LAST-induced prolong cardiac arrest.3Since then, lipid emulsion has been used successfully in lipophilic drug overdoses, such as tricyclic antidepressants, bupropion, verapamil, diltiazem, caffeine, and olanzapine. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/04/23 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1199674315 ER -