Unusual presentation of local anesthetic toxicity

Hayaran, Nitin; Sardana, Rashi; Nandinie, Hamse; Jain, Aparna

doi:10.1016/j.jclinane.2016.08.039

Cited by 13 publications

(13 citation statements)

References 4 publications

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“…5,9,11,17,23,[32][33][34] The remaining cases resulted from neuraxial (13%: 4 of the 6 were epidural, 2 were described specifically as caudal injections), 16,20,26,29,30,38 paravertebral blocks (8.5%), 15,21,22,30 lower (8.5%) 6,7,13 and upper (8.5%) 6,31,36,39 extremity blocks, head and neck blocks (8.5%) (maxillary nerve, peribulbar), 14,19 topical, 28,35,37 transabdominis plane blocks, 8 and intravenous administration. 18 Seven cases (15%) involved continuous infusions of local anesthetic.…”

Section: Block Typesmentioning

confidence: 99%

“…9,11,13,15,16,19,29,33,34,38 In 2 cases, the presence or absence of an intravascular marker was irrelevant. In 1 case, the local anesthetic was purposefully injected intravenously to blunt the clinical response to tracheal extubation, 18 and in another, the patient self-administered a topical preparation.…”

Section: Vascular Markersmentioning

confidence: 99%

“…Twenty-two patients (47%) were treated with ILE. 5,[7][8][9][10][11][12]14,15,17,21,23,24,26,29,30,32,34,37,39 In 1 case report, 39 ClinOleic 20% emulsion (Baxter, Deerfield, Illinois) was used instead of ILE. Nine patients received both a benzodiazepine and ILE.…”

Section: Treatment Of Lastmentioning

confidence: 99%

“…Nine patients received both a benzodiazepine and ILE. [7][8][9]12,14,21,32,34,39 Lack of details on the timing of ILE administration in relation to the onset of LAST precluded detailed analysis. Timing of ILE was under 10 minutes (n = 8), or ILE was given at 20, 30, 40, and more than 60 min after onset of LAST.…”

Section: Treatment Of Lastmentioning

confidence: 99%

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Local Anesthetic Systemic Toxicity

Gitman

Barrington

2018

Regional Anesthesia and Pain Medicine

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This review summarizes presenting features, management, and outcomes of local anesthetic systemic toxicity (LAST) from published cases and those submitted to online registries capturing use of intravenous lipid emulsion (ILE) therapy. The results of single-center and multicenter registries and epidemiologic studies complement this information. Between March 2014 and November 2016, 47 separate cases of LAST were described in 35 peer-reviewed articles. Local anesthetic systemic toxicity events occurred as a result of penile blocks (23%), local infiltration (17%), and upper/lower extremity, torso, and neuraxial blockade. Twenty-two patients (47%) were treated with ILE, and 2 patients (4.3%) died. During the same time period, 11 cases submitted to lipidrescue.org were treated with ILE and survived. The incidence of LAST reported in registries is 0.03% or 0.27 (95% confidence interval, 0.21-0.35) per 1000 peripheral nerve blocks (denominator of 251,325). Seizure (53% and 61% from case reports and registries, respectively) was the most common presenting feature.

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Section: Block Typesmentioning

confidence: 99%

Section: Vascular Markersmentioning

confidence: 99%

Section: Treatment Of Lastmentioning

confidence: 99%

Section: Treatment Of Lastmentioning

confidence: 99%

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Local Anesthetic Systemic Toxicity

Gitman

Barrington

2018

Regional Anesthesia and Pain Medicine

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“…Besides classic neurological complication of LAST such as circumoral numbness and seizure, unusual CNS presentations were discussed. Despite careful drug dosage, isolated unresponsiveness without respiratory and hemodynamic depression has been reported after dental surgery using lignocaine (Hayaran et al 2017). In this case, a mixture of 2% lignocaine and adrenaline was infiltrated into the inner surface of the lower lip and vestibule.…”

Section: Discussionmentioning

confidence: 91%

Local Anaesthesia Systemic Toxicity (LAST) – A Stroke Mimicker

Leong¹

2019

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Ketoksikan sistematik bius lokal (KSBL) adalah satu kejadian yang jarang berlaku tetapi boleh mengancam nyawa dan terjadi selepas suntikan blok pada saraf periferal. Kejadian ini mungkin berpunca dari pelbagai faktor termasuk pilihan ubat, teknik pemberian ubat atau faktor risiko pesakit sendiri. Kami melaporkan satu kes seorang wanita berusia 55 tahun yang menghidap pening kepala, percakapan telor dan lumpuh kesemua tangan dan kaki selepas beliau menerima suntikan campuran ubat lignocaine dan hidrokortison pada sendi di bahu kanan. Pemeriksaan neurologi menunjukkan ton otot lemah dan skala kekuatan otot kaki dan tangan 0/5. Kejadian-kejadian toksik ini mungkin disebabkan oleh suntikan yang tidak disengajakan ke dalam salur darah arteri atau lapisan dura pada saraf atau penyerapan ubat dari tisu berdekatan. Laporan kes ini menceritakan tentang suntikan ke dalam sendi bahu yang boleh menyebabkan KSBL yang mungkin tidak dikenalpasti kerana ia boleh menyerupai strok.

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Lidocaine

2016

Reactions Weekly

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Unusual presentation of local anesthetic toxicity

Cited by 13 publications

References 4 publications

Local Anesthetic Systemic Toxicity

Local Anesthetic Systemic Toxicity

Local Anaesthesia Systemic Toxicity (LAST) – A Stroke Mimicker

Lidocaine

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