Local Anesthetic Toxicity Questions & Answers

Updated: Jan 09, 2019
  • Author: Raffi Kapitanyan, MD; Chief Editor: David Vearrier, MD, MPH  more...
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Questions & Answers

Overview

How safe are local anesthetic agents?

How are toxicity manifestations of local anesthetic agents categorized?

What are CNS manifestations of local anesthetic toxicity?

What are cardiovascular manifestations of local anesthetic toxicity?

What are hematologic manifestations of local anesthetic toxicity?

What are allergic manifestations of local anesthetic toxicity?

How is local anesthetic toxicity evaluated?

How is local anesthetic toxicity managed?

What causes local anesthetic toxicity?

How do local and systemic toxicity differ in local anesthetic toxicity?

How does local anesthetic toxicity affect the CNS?

What causes cardiovascular effects of local anesthetic toxicity?

Which factors influence the action, potency, and duration of local anesthetics?

How is concentration and dilution measured in local anesthetic toxicity?

What is the pathogenesis of CNS manifestations of local anesthetic toxicity?

What causes cardiovascular effects in local anesthetic toxicity?

How are local anesthetic agents categorized?

What local anesthetic agents were developed as a result of bupivacaine toxicity?

What is the minimum doses of local anesthetic that can cause toxicity?

What are risk factors for local anesthetic toxicity?

What is the incidence of local anesthetic toxicity in the US?

What is the typical progression for local anesthetic toxicity?

How should patients be advised following an episode of local anesthetic toxicity?

Presentation

What are the signs and symptoms of local anesthetic toxicity and how quickly do they appear?

What are the categories of local anesthetic toxicity manifestations?

What are the CNS manifestations of local anesthetic toxicity?

What are cardiovascular manifestations of local anesthetic toxicity?

What are hematologic manifestations of local anesthetic toxicity?

What are allergic manifestations of local anesthetic toxicity?

What are local tissue manifestations of local anesthetic toxicity?

What are the signs and symptoms of toxicity due to local topical anesthetic agents?

What are the adverse effects of local anesthetic mixtures containing cocaine?

DDX

What are the differential diagnoses for Local Anesthetic Toxicity?

Workup

What should be included in the evaluation of local anesthetic toxicity?

Treatment

What is the initial treatment of local anesthetic toxicity?

What is the role of IV infusion of lipid emulsions in the treatment of local anesthetic toxicity?

What are the treatment options for allergic reactions of local anesthetic toxicity?

How are local ischemic or nerve toxicities managed in local anesthetic toxicity?

When is inpatient treatment indicated for local anesthetic toxicity?

How is local anesthetic toxicity prevented?

Which groups have issued treatment guidelines for local anesthetic toxicity?

How should CNS manifestations of local anesthetic toxicity be treated?

How should cardiovascular manifestations of local anesthetic toxicity be treated?

When is lipid emulsion therapy indicated for treatment of local anesthetic toxicity?

What is the efficacy of lipid emulsion therapy for treatment of local anesthetic toxicity?

What is the recommended dosing regimen for lipid emulsion therapy for local anesthetic toxicity?

What are the treatment options for allergic reactions in local anesthetic toxicity?

How can local anesthetic toxicity be prevented?

What are dosage guidelines for local anesthetic agents?

What consultations are warranted in cases of local anesthetic toxicity?

Medications

What are the goals of drug treatment for local anesthetic toxicity?

Which medications in the drug class Neuromuscular Blockers, Depolarizing are used in the treatment of Local Anesthetic Toxicity?

Which medications in the drug class Anxiolytics, Benzodiazepines are used in the treatment of Local Anesthetic Toxicity?

Which medications in the drug class Anticonvulsants, Barbiturates are used in the treatment of Local Anesthetic Toxicity?