Treatment of severe local anaesthetic toxicity

摘要

The Association of Anaesthetists recently disseminated guidelines for the management of severe local anaesthetic toxicity, referencing animal models and case reports of treatment with Intra-lipid . The guidelines consider Intralipid only in the context of cardiac arrest. However, the clinical threshold and time for giving Intralipid has been decreasing with each successive report. The doses injected have increased well above initial recommendations . With experiments suggesting that Intralipid has a role in verapamil , propranolol and clomipramine toxicity, indications for its use are likely to widen. Given the enthusiasm for this treatment and the circumstances of potential iatrogenic injury, it is probably only a matter of time before prophylactic Intralipid use is reported