Lipid Rescue: Lifesaving Treatment for Toxicity and Cardiac Arrest Secondary to Local Anesthetics Including Bupivacaine

Abstract

The occurrence of toxicity from local anesthetics has been reported, including cardiac toxicity resulting in cardiac arrhythmias and/or asystole. A variety of techniques have been used to treat local anesthetic toxicities; however, with cardiac arrest, a relatively new concept—lipid rescue—has been formulated that appears to be relatively successful. The author discusses the literature on local anesthetic toxicities and fatalities, animal research concerning lipid rescue, local anesthetic toxicities, and fatalities treated with lipid rescue, as well as the Practice Advisory on Treatment of Local Anesthetic Systemic Toxicity.