Lipid Emulsion for Local Anesthetic Systemic Toxicity

The accidental overdose of local anesthetics may prove fatal. The commonly used amide local anesthetics have varying adverse effects on the myocardium, and beyond a certain dose all are capable of causing death. Local anesthetics are the most frequently used drugs amongst anesthetists and although u...

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Main Authors: Sarah Ciechanowicz, Vinod Patil
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Anesthesiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2012/131784
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author Sarah Ciechanowicz
Vinod Patil
author_facet Sarah Ciechanowicz
Vinod Patil
author_sort Sarah Ciechanowicz
collection DOAJ
description The accidental overdose of local anesthetics may prove fatal. The commonly used amide local anesthetics have varying adverse effects on the myocardium, and beyond a certain dose all are capable of causing death. Local anesthetics are the most frequently used drugs amongst anesthetists and although uncommon, local anaesthetic systemic toxicity accounts for a high proportion of mortality, with local anaesthetic-induced cardiac arrest particularly resistant to standard resuscitation methods. Over the last decade, there has been convincing evidence of intravenous lipid emulsions as a rescue in local anesthetic-cardiotoxicity, and anesthetic organisations, over the globe have developed guidelines on the use of this drug. Despite this, awareness amongst practitioners appears to be lacking. All who use local anesthetics in their practice should have an appreciation of patients at high risk of toxicity, early symptoms and signs of toxicity, preventative measures when using local anesthetics, and the initial management of systemic toxicity with intravenous lipid emulsion. In this paper we intend to discuss the pharmacology and pathophysiology of local anesthetics and toxicity, and the rationale for lipid emulsion therapy.
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spelling doaj-art-970eb3286565461eb364d79bf366d5602025-08-20T02:09:51ZengWileyAnesthesiology Research and Practice1687-69621687-69702012-01-01201210.1155/2012/131784131784Lipid Emulsion for Local Anesthetic Systemic ToxicitySarah Ciechanowicz0Vinod Patil1Department of Anaesthesia, BHR University Hospitals NHS Trust, Romford, London RM7 0AG, UKDepartment of Anaesthesia, BHR University Hospitals NHS Trust, Romford, London RM7 0AG, UKThe accidental overdose of local anesthetics may prove fatal. The commonly used amide local anesthetics have varying adverse effects on the myocardium, and beyond a certain dose all are capable of causing death. Local anesthetics are the most frequently used drugs amongst anesthetists and although uncommon, local anaesthetic systemic toxicity accounts for a high proportion of mortality, with local anaesthetic-induced cardiac arrest particularly resistant to standard resuscitation methods. Over the last decade, there has been convincing evidence of intravenous lipid emulsions as a rescue in local anesthetic-cardiotoxicity, and anesthetic organisations, over the globe have developed guidelines on the use of this drug. Despite this, awareness amongst practitioners appears to be lacking. All who use local anesthetics in their practice should have an appreciation of patients at high risk of toxicity, early symptoms and signs of toxicity, preventative measures when using local anesthetics, and the initial management of systemic toxicity with intravenous lipid emulsion. In this paper we intend to discuss the pharmacology and pathophysiology of local anesthetics and toxicity, and the rationale for lipid emulsion therapy.http://dx.doi.org/10.1155/2012/131784
spellingShingle Sarah Ciechanowicz
Vinod Patil
Lipid Emulsion for Local Anesthetic Systemic Toxicity
Anesthesiology Research and Practice
title Lipid Emulsion for Local Anesthetic Systemic Toxicity
title_full Lipid Emulsion for Local Anesthetic Systemic Toxicity
title_fullStr Lipid Emulsion for Local Anesthetic Systemic Toxicity
title_full_unstemmed Lipid Emulsion for Local Anesthetic Systemic Toxicity
title_short Lipid Emulsion for Local Anesthetic Systemic Toxicity
title_sort lipid emulsion for local anesthetic systemic toxicity
url http://dx.doi.org/10.1155/2012/131784
work_keys_str_mv AT sarahciechanowicz lipidemulsionforlocalanestheticsystemictoxicity
AT vinodpatil lipidemulsionforlocalanestheticsystemictoxicity