background: our aim was to evaluate the effect of intravenous intralipid administration as an antidote on the poisoned patients' glasgow coma scale (gcs), hemodynamic parameters, arterial blood gas analysis, and routine metabolic profile tests (i.e. urea, glucose, sodium, and potassium) in the setting of non-local anesthetic drug overdose. methods: in this randomized controlled trial, a to...

Local anesthetic systemic toxicity (LAST) is a rare but avoidable consequence of local anesthetic overdose. This article will review the mechanism of action of local anesthetic toxicity and the signs and symptoms of LAST. Due to physiologic and anatomic differences between children and adults, LAST occurs more frequently in children; particularly when 3% mepivacaine is administered. The calcula...

Intravenous lipid emulsion is an established, effective treatment for local anesthetic-induced cardiovascular collapse. The predominant theory for its mechanism of action is that by creating an expanded, intravascular lipid phase, equilibria are established that drive the offending drug from target tissues into the newly formed 'lipid sink'. Based on this hypothesis, lipid emulsion has been con...

Background: Our aim was to evaluate the effect of intravenous intralipid administration as an antidote on the poisoned patients' Glasgow Coma Scale (GCS), hemodynamic parameters, arterial blood gas analysis, and routine metabolic profile tests (i.e. urea, glucose, sodium, and potassium) in the setting of non-local anesthetic drug overdose. Methods: In this randomized controlled trial, a tota...

Although local anesthetics have an acceptable safety profile, significant morbidity and mortality have been associated with their use. Inadvertent intravascular injection of local anesthetics and/or the use of excessive doses have been the most frequent causes of local anesthetic systemic toxicity (LAST). Furthermore, excessive doses of local anesthetics injected locally into the tissues may le...

Local anesthetics are commonly used in the perioperative environment to facilitate surgical procedures or to provide postoperative pain management for patients. The use of local anesthetics, however, introduces the risk of complications resulting from local anesthetic systemic toxicity and the risks of increased morbidity and mortality for the surgical patient. Systemic toxicity from the inject...

Cardiovascular collapse from accidental local anesthetic toxicity is a rare but catastrophic complication of regional anesthesia. The long-acting amide local anesthetics bupivacaine, levobupivacaine and ropivacaine have differential cardiac toxicity, but all are capable of causing death with accidental overdose. In recent times, the chance discovery that lipid emulsion may improve the chance of...

context lumbar central spinal stenosis is common and often results in chronic persistent pain and disability, which can lead to multiple interventions. after the failure of conservative treatment, either surgical or nonsurgical modalities such as epidural injections are contemplated in the management of lumbar spinal stenosis. evidence acquisition recent randomized trials, systematic reviews an...

Severe, systemic local anesthetic toxicity is arguably the most feared complication of regional anesthesia. A combination of old and new therapies is recommended to reduce the morbidity and mortality of symptomatic local anesthetic overdose. Prevention remains the criterion standard for improving patient safety during regional anesthesia. However, when local anesthetic toxicity occurs, consider...

introduction: although patients do not experience sever pain after laparoscopic surgery, most of them experience acute or chronic pain afterward. while conventional pain killers including nsaid and narcotics in laparoscopic surgery have specific side effects, their application is inevitable. this study compares the efficacy of local anesthetic drugs and conventional pain killers in post-operati...