Use of Intravenous Lipid Emulsion to Reverse Central Nervous System Toxicity of an Iatrogenic Local Anesthetic Overdose in a Patient on Peritoneal Dialysis

Lange, Dirk; Schwartz, Daniel; DaRoza, Gerald; Gair, Robert D

doi:10.1345/aph.1r298

Cited by 21 publications

(15 citation statements)

References 14 publications

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“…Anesthesiologists or anesthesiology trainees were involved in most of the cases (65%), whereas the remaining 35% involved dentists (n = 3), 20,23,49 dermatologists (n = 2), 48,50 surgeons (n = 4), 13,51,58,60 general practitioners (n = 2), 30 a nephrologist (n = 1), 46 a pediatrician (n = 1), 39 a nurse (n = 1), 14 a cardiologist (n = 1), 10 or unspecified operators.…”

Section: Setting Of Lastmentioning

confidence: 99%

“…[8][9][10][12][13][14][15][16][17][18][19][20][21][22]24,25,[27][28][29][31][32][33][34][36][37][38][40][41][42][43][51][52][53][54][55][56][57][58]60,61 Twelve percent of the cases developed in an office, 30,39,45,46,[48][49][50] whereas another 4% occurred in other locations, including the patient's home. Finally, 15% of the authors did not specify the hospital setting where the LA was administered.…”

Section: Setting Of Lastmentioning

confidence: 99%

See 1 more Smart Citation

A Review of Local Anesthetic Systemic Toxicity Cases Since Publication of the American Society of Regional Anesthesia Recommendations

Vasques

Behr

Weinberg

et al. 2015

Regional Anesthesia and Pain Medicine

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Local anesthetic systemic toxicity (LAST) occurrence may cross several medical specialties. In 2010, the American Society of Regional Anesthesia and Pain Medicine (ASRA) published the first algorithm on LAST management, introducing the use of lipid emulsion (ILE) treatment. In the present study, we retrieved the cases of LAST published between ASRA guidelines dissemination and March 2014. We analyzed the reported clinical manifestations of LAST, characteristics of affected patients, onset time of toxicity, and clinical setting. We also focused on the treatment measures that were applied in the different cases, especially on the use of ILE and adherence to ASRA recommendations. Despite the limits of a review of case reports, the present study calls attention to the insidious nature of LAST, especially its atypical manifestations, and shows that ILE may currently be underadministered in daily clinical practice, especially in nonanesthesiology practice.

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Section: Setting Of Lastmentioning

confidence: 99%

Section: Setting Of Lastmentioning

confidence: 99%

A Review of Local Anesthetic Systemic Toxicity Cases Since Publication of the American Society of Regional Anesthesia Recommendations

Vasques

Behr

Weinberg

et al. 2015

Regional Anesthesia and Pain Medicine

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“…Bupivacaine is a type of surgical local anesthetic, and studies have demonstrated that the excessive administration of bupivacaine results in central nervous system and cardiovascular system poisoning (7,8). Bupivacaine has been wildly used in clinical surgeries such as tonsillectomy, neuroleptanalgesia and tumor resections.…”

Section: Introductionmentioning

confidence: 99%

Protective role of LRRC3B in preventing breast cancer metastasis and recurrence post-bupivacaine

Kong

Zou

2017

Oncology Letters

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Abstract. The present study aimed to investigate the potential effect of leucine-rich repeat containing 3B (LRRC3B) with respect to the inhibition of breast cancer recurrence and metastasis post-anesthesia. The mRNA expression of LRRC3B in breast MDA-MB-231 and MCF-7 cell lines was detected using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) analysis. The effect of bupivacaine on breast cancer cell invasion was analyzed using a Matrigel assay. LRRC3B specific small interfering (si)RNA was constructed and transfected into breast cancer cells using Lipofectamine ® 2000 reagent. The influence of bupivacaine on LRRC3B expression was measured based on RT-qPCR. Additionally, the effect of LRRC3B silencing on the invasion of breast cancer cells treated with bupivacaine was analyzed. Compared with the control, LRRC3B expression significantly increased in MDA-MB-231 and in MCF-7 cells as the length of time increased (P<0.05), but the expression of the gene significantly declined in 2 types of cancer cell when the cells were transfected with siRNA-LRRC3B plasma (P<0.05). The administration of 50 µg/ml bupivacaine promoted maximum breast cancer cell invasion, and suppressed LRRC3B mRNA expression in cells. However, when LRRC3B was silenced in cancer cells, 20 µg/ml bupivacaine significantly promoted cancer cell invasion, indicating that bupivacaine suppresses the expression of LRRC3B and promotes cell invasion. The present study suggested that LRRC3B serves a protective role in preventing bupivacaine-induced breast cancer recurrence and metastasis.

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“…Intravenous lipid emulsion can be used to treat cardiovascular and central nervous system failure [8]. Our patient does not require lipid therapy and his seizures were controlled effectively with antiepileptic.…”

Section: Discussionmentioning

confidence: 81%

Local Anaesthetic Systemic Toxicity in a Patient under General Anaesthesia (GA): A Diagnostic Challenge

Prakash

Kumar

Singh

2015

JCDR

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Use of Intravenous Lipid Emulsion to Reverse Central Nervous System Toxicity of an Iatrogenic Local Anesthetic Overdose in a Patient on Peritoneal Dialysis

Abstract: Central nervous system toxicity due to an overdose of lidocaine was quickly reversed by intravenous lipid emulsion in our patient.

Cited by 21 publications

References 14 publications

A Review of Local Anesthetic Systemic Toxicity Cases Since Publication of the American Society of Regional Anesthesia Recommendations

A Review of Local Anesthetic Systemic Toxicity Cases Since Publication of the American Society of Regional Anesthesia Recommendations

Protective role of LRRC3B in preventing breast cancer metastasis and recurrence post-bupivacaine

Local Anaesthetic Systemic Toxicity in a Patient under General Anaesthesia (GA): A Diagnostic Challenge

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