Local Anesthetic Systemic Toxicity (LAST): More Common Than You Think

Area of Science:

• Anesthesiology
• Emergency Medicine
• Toxicology

Background:

• Outpatient anesthetic body procedures are increasing, with potential for serious complications like local anesthetic systemic toxicity (LAST).
• LAST is a rare but significant cause of morbidity, with diverse symptoms and potential sequelae.
• Emergency department (ED) staff require awareness of LAST, its risk factors, and management protocols.

Purpose of the Study:

• To highlight the importance of recognizing and managing local anesthetic systemic toxicity (LAST) in the emergency department.
• To inform ED staff about the diverse clinical presentations and potential outcomes of LAST.
• To emphasize the need for awareness regarding LAST mechanisms, risk factors, prevention, and treatment.

Main Methods:

• Review of existing literature on local anesthetic systemic toxicity.
• Analysis of contributing factors to LAST development.
• Discussion of clinical manifestations and management strategies for LAST.

Main Results:

• Local anesthetic systemic toxicity can cause life-threatening neurologic and cardiovascular effects.
• Risk factors for LAST include the anesthetic agent and site of administration.
• Prompt recognition and appropriate management are crucial for patient outcomes.

Conclusions:

• Emergency department preparedness for local anesthetic systemic toxicity is essential due to increasing outpatient procedures.
• Comprehensive understanding of LAST mechanisms, risk factors, and treatment is vital for ED staff.
• Minimizing LAST risk requires heightened awareness and adherence to best practices in anesthetic care.