RT Book, Section
A1 Li, Yunping
A2 Hess, Philip E.
A2 Li, Yunping
A2 Kowalczyk, John J.
A2 Stiles, Justin K.
SR Print(0)
ID 1199674315
T1 Local Anesthetic Systemic Toxicity
T2 Obstetric Anesthesia: Quick References & Practical Guides
YR 2023
FD 2023
PB McGraw Hill
PP New York, NY
SN 9781264671465
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1199674315
RD 2023/09/27
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.