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[Systemic toxicity of local anaesthetics in children]

O S Geodakian

    Anesteziologiia I Reanimatologiia
    |April 7, 2015
    PubMed

    Insights

    This review analyzes local anesthetic systemic toxicity (LAST) in regional anesthesia, detailing its symptoms, neurotoxicity, and cardiotoxicity in children. It also covers modified treatment protocols, including lipid resuscitation, and prophylaxis strategies.

    Area of Science:

    • Anesthesiology
    • Toxicology

    Context:

    • Regional anesthesia carries the risk of local anesthetic systemic toxicity (LAST), a potentially lethal complication.
    • Understanding LAST is crucial for safe anesthetic practice, especially in pediatric patients.

    Purpose:

    • To review and synthesize current knowledge on local anesthetic systemic toxicity (LAST).
    • To highlight differences in LAST presentation and management between adults and children.
    • To discuss updated treatment protocols and prophylactic measures for LAST.

    Summary:

    • The article examines systemic absorption, neurotoxicity, and cardiotoxicity of local anesthetics, with a focus on pediatric and neonatal populations.
    • Clinical signs of LAST in adults versus children, and bupivacaine dosage are discussed.
    • A modified treatment protocol involving lipid resuscitation (Intralipid) and resuscitation scenarios are presented.

    Impact:

    • Provides a comprehensive overview of LAST, aiding clinicians in recognizing and managing this critical condition.
    • Offers guidance on pediatric LAST, addressing a vulnerable patient group.
    • Recommends strategies for LAST prophylaxis and emergency management, potentially improving patient outcomes.

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