From Bupivacaine to Intralipid: Leading Edge

Intravenous lipid emulsion therapy was introduced as a treatment for local anesthetic toxicity it has shown couple of reversing and therapeutic efficacies for a number of different drug toxicities. In recent papers many different applications of Intralipid or oil containing products-Lipid Emulsion-have successfully experimented in critical care patients. In 1998 Dr. Weinberg began working on the effects of local anesthetics and discovered that an infusion of lipid emulsion not only protect against but also correct local anesthetic cardiac toxicity. The first case report of successful Lipid Rescue was published in 2006. Reportedly lipid infusion was successful in reversing neurological signs of toxicity from local anesthetics. With appearing more evidences for intralipid different applications there is a hope that many types of drug-induced CNS or cardiac toxicities could be treated by Lipid Rescue effect as a safe treatment option. Since identification of lipid resuscitation therapy in 1998 as a treatment for LA toxicity by Weinberg [1], many studies and experiments have been performed in order to explore more the mechanism of this novel treatment. Intralipid has been used as a source of energy and essential fatty acids for parenteral nutrition. Intralipid is an emulsion of soy bean oil, egg phospholipids and glycerin, and is available in 10%, 20% and 30% concentrations. The 30% concentration has not been approved for direct intravenous infusion. Intralipid and other balanced lipid emulsions provide essential fatty acids. In this review some of the novel applications of Intralipid have introduced.