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- W4367322011 abstract "Abstract Local anesthetic systemic toxicity (LAST) is a life-threatening adverse event related to the administration of local anesthetics (LAs). Its presentation does not always follow the classic symptomatology of central nervous system excitatory symptoms followed by cardiotoxicity and arrest or collapse; many of the cases develop subtle symptoms that may go unreported. LAST happens if the LA level exceeds the capacity to be metabolized from the plasma and buffers are overwhelmed. The free fraction of the drug increases and the risks of accumulation and toxicity rise. Patients at the extremes of age, parturient, patients with end organ dysfunction, as well as those receiving high doses of LA due to concomitant administration, are at the highest risk. Also, the site of injection influences significantly the peak plasma concentration and the time to reach it. The American Society of Regional Anesthesia and Pain Medicine published an algorithm to treat LAST. Its pharmacologic treatment depends mainly on the administration of lipid emulsion. However, the resuscitation algorithm is different from other cardiac arrest scenarios. The best treatment of LAST is prevention; one must be vigilant concerning all the possible causes that contribute to LAST before planning a regional anesthetic nerve block." @default.
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- W4367322011 date "2023-04-01" @default.
- W4367322011 modified "2023-10-17" @default.
- W4367322011 title "Local Anesthetic Systemic Toxicity" @default.
- W4367322011 doi "https://doi.org/10.1093/med/9780197518519.003.0006" @default.
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