Intensive therapy systemic toxicity of local anesthetics (clinical guidelines)

Roman E. Lakhin; V. A Koryachkin; D. N Uvarov; G. E Ulrikh; E. M Shifman; V. A Gluschenko; A. V Kulikov

doi:10.17816/RA42838

Regional Anesthesia and Acute Pain Management ›› 2016, Vol. 10 ›› Issue (3) : 197 -204. DOI: 10.17816/RA42838

Articles

research-article

Intensive therapy systemic toxicity of local anesthetics (clinical guidelines)

Author information +

History +

PDF

Abstract

Development of the systemic toxicity of local anesthetics can quickly lead to severe bradycardia and hypotension, up to cardiac arrest. The presented clinical recommendations designed to optimize medical care and are included in the list of mandatory clinical protocols according to the Helsinki Declaration on Patient Safety in Anaesthesiology. This review summarizes the main mechanisms of toxicity when using local anesthetics. The guidelines set out criteria and signs of systemic toxicity, recommendations for its prevention. The algorithm of action and recommended dosage of drugs. An intensive care protocol systemic toxicity of local anesthetics including the use of lipid emulsion.

Keywords

local anesthetics / systemic toxicity / regional anesthesia / intensive care / lipid emulsion

Cite this article

Download citation ▾

Roman E. Lakhin, V. A Koryachkin, D. N Uvarov, G. E Ulrikh, E. M Shifman, V. A Gluschenko, A. V Kulikov. Intensive therapy systemic toxicity of local anesthetics (clinical guidelines). Regional Anesthesia and Acute Pain Management, 2016, 10(3): 197-204 DOI:10.17816/RA42838

登录浏览全文

4963

注册一个新账户忘记密码

References

Publishing order | Descend order by publishing year | Descend order by cited within

[1]	Dillane D., Finucane B. T. Local Anesthetic systemic toxicity. Canadian Journal of Anesthesia. 2010; 57: 368-80.

[2]	Neal J.M., Bernards C.M., Butterworth J.F.et al. ASRA practice advisory on local anesthetic systemic toxicity. Regional Anesth. Pain Med. 2010; 35(2): 152-61.

[3]	Neal J.N. Mulroy M.F., Weinberg G.L. American Society of Regional Anesthesia and Pain Medicine Checklist for treatment of Local Anesthetic Systemic Toxicity: 2012 Version. Reg Anesth Pain Med. 2012; 37(1): 16-8.

[4]	The Association of Anaesthetists of Great Britain & Ireland. Guidelines for the Management of Severe Local Anaesthetic Toxicity. Available at: http://aagbi.org/sites/default/files/la_toxicity_2010_0.pdf.

[5]	Mellin-Olsen J., Staender S., Whitaker D.K., Smith A.F. The Helsinki Declaration on Patient Safety in Anaesthesiology. EurJAnaesthesiol. 2010; 27(7): 592-97.

[6]	Международная классификация болезней, травм и состояний, влияющих на здоровье 10-го пересмотра (МКБ-10) (Всемирная организация здравоохранения, 1994). Available at: http://www.mkb10.ru/.

[7]	Номенклатура медицинских услуг (Министерство здравоохранения и социального развития Российской Федерации, 2011г.). Availableat: https://www.rosminzdrav.ru/documents/6975-prikaz-minzdravsotsrazvitiya-rossii-1664n-ot-27-dekabrya-2011-g.

[8]	Di Gregorio G., Neal J.M., Rosenquist R.W., Weinberg G.L. Clinical presentation of local anesthetic systemic toxicity: a review of published cases, 1979 to 2009. Reg. Anesth. Pain. Med. 2010; 35(2): 181-87.

[9]	Ruan W., French D., Wong A., Drasner K., Wu A.H.B A mixed (longand mediumchain) triglyceride lipid emulsion extracts local anesthetic from human serum in vitro more effectively than a longchain emulsion. Anesthesiology. 2012; 116 (2): 334-39.