TY - CHAP M1 - Book, Section TI - Local Anesthetic Systemic Toxicity A1 - Gitman, Marina A1 - Fettiplace, Michael A1 - Weinberg, Guy A2 - Hadzic, Admir PY - 2017 T2 - Hadzic's Textbook of Regional Anesthesia and Acute Pain Management, 2e AB - The introduction of cocaine as the first local anesthetic (LA) in the late nineteenth century was soon accompanied by reports of its systemic toxicity. The symptoms of toxicity were frequently described as seizures or respiratory failure, but some cases also included accounts of adverse cardiac effects. Often lethal, local anesthetic systemic toxicity (LAST) was treated with caffeine, ammonia, or even hypodermic ether.1 The development of procaine in 1904 did not solve the problem of systemic toxicity, and the Committee for the Study of Toxic Effects of Local Anesthetics published a report of 43 fatal cases linked to the use of LAs.2 Identification of contributing factors, emphasis on prevention and the almost-complete elimination of cocaine from clinical practice helped decrease the incidence of LAST for nearly 50 years. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1141737666 ER -