Local Anaesthesia Toxicity (LAST)

EMKF #FOAMed

  • The key in managing LAST is prevention. Know your dose, know your maximum dose, always aspirate prior to injection and ask patient about symptoms
  • Lidocaine toxicity cardiovascular complications are typically preceded by neurological signs/symptoms. If these develop, stop administration, place patient on monitor and ready your antidote
  • Bupivacaine toxicity can be sudden and catastrophic. If you are using the drug, undershoot your max dose and know where your antidote is
  • Intralipid has been shown to be effective in LAST. Administer the drug anytime there are signs of hemodynamic compromise

 

EMKF

Emergency Medicine Kenya Foundation (EMKF) is a not-for-profit (NGO) public benefit organisation registered in Kenya