RT Book, Section
A1 Wasson, Cassandra
A1 Peterson, Stacy
A2 Ellinas, Herodotos
A2 Matthes, Kai
A2 Alrayashi, Walid
A2 Bilge, Aykut
SR Print(0)
ID 1176457222
T1 Local Anesthetics
T2 Clinical Pediatric Anesthesiology
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781259585746
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1176457222
RD 2024/04/20
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.