MANAGEMENT OF LOCAL ANAESTHETIC SYSTEMIC TOXICITY

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MANAGEMENT OF LOCAL ANAESTHETIC SYSTEMIC TOXICITY Ensure 100% oxygenation via mask or endotracheal tube Treat hypotension, bradycardia, arrhythmia Treat seizures with midazolam or thiopentone Airway Breathing Circulation Call for help & get LIPID EMULSION Activate cardiopulmonary bypass team Stop injecting local anaesthetic STOP >70kg Bolus-100ml over 2-3min Infusion- 250ml over 15min <70kg Bolus-1.5ml/kg over 2-3 min Infusion- 0.25ml/kg/min Unstable Maximum 3 boluses Maximum dose-12ml/kg After 5min Avoid vasopressin, beta blockers, calcium channel blockers, local anaesthetics, propofol Use adrenaline in low doses (<1mcg/kg) Monitor in ICU for upto 6h INTRAVENOUS LIPID EMULSION THERAPY Step 1 Step 2 Step 3 Stable Repeat bolus & Double the infusion CAUTION! Intralipid 20% LIPID EMULSION Paediatric dose 1.5-2ml/kg

Transcript of MANAGEMENT OF LOCAL ANAESTHETIC SYSTEMIC TOXICITY

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MANAGEMENT OF LOCAL ANAESTHETIC SYSTEMIC TOXICITY

Ensure 100% oxygenation via mask or endotracheal tube Treat hypotension, bradycardia, arrhythmia Treat seizures with midazolam or thiopentone

Airway

Breathing Circulation

Call for help & get LIPID EMULSION

Activate cardiopulmonary

bypass teamStop injecting local

anaesthetic

STOP

>70kg Bolus-100ml over 2-3min

Infusion- 250ml over 15min

<70kg Bolus-1.5ml/kg over 2-3 min

Infusion- 0.25ml/kg/min

Unstable

Maximum 3 boluses Maximum dose-12ml/kg

After 5min

Avoid vasopressin, beta blockers, calcium channel blockers, local

anaesthetics, propofol

Use adrenaline in low doses (<1mcg/kg)

Monitor in ICU for upto 6h

INTRAVENOUS LIPID EMULSION THERAPY

Step 1

Step 2

Step 3

Stable Repeat bolus &

Double the infusion

CAUTION!

Intralipid

20% LIPID

EMULSION Paediatric

dose 1.5-2ml/kg

Local anesthetic systemic toxicity: Continuing Professional … · This impairs excitation-contraction coupling, thereby reducing contractility. Local anesthetics also impair mitochondrial

Local anesthetic systemic toxicity: Continuing Professional … · This impairs excitation-contraction coupling, thereby reducing contractility. Local anesthetics also impair mitochondrial

Local Anaesthesia for Minor · PDF fileLocal Anaesthesia for Minor Procedures Page: 4 of 10 Signs of local anaesthetic toxicitySigns of local anaesthetic toxicity Local anaesthetics

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Systemic Toxicity and Hypersensitivity

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EPA QUANTITATIVE MODEL OF SYSTEMIC TOXICITY USING …

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Acute systemic toxicity testing: Past, present, and futureAcute systemic toxicity testing: Past, present, and future Amy J. Clippinger, Ph.D. PETA International Science Consortium

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Local Anaesthetic Systemic Toxicity (LAST) · PDF file25.06.2012 · Local Anaesthetic Systemic Toxicity (LAST) Part II Course, June 2012 Dr Michael Barrington St Vincent’s Hospital,

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1 Determinants of Repeated exposure Toxicity *If acute toxicity studies show a potential for cumulative local or systemic toxicity. *Exposure of humans.

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Anaesthetic Trainees- The Trauma Call at SMH Anaesthetic ...

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Systemic Lupus Erythematosus (SLE) Therapy: The Old and the New · 2020-06-02 · of systemic lupus erythematosus (SLE), disease activity, comorbidities and drug toxicity signif-icantly

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blue attenuates acute thallium systemic toxicity in rats.

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