Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina Campus, Columbia, South Carolina, USA.
Ther Clin Risk Manag. 2010 Oct 5;6:449-51. doi: 10.2147/TCRM.S11861.
Is intravenous lipid emulsion a safe and effective therapy for the reversal and treatment of local anesthetic toxicity?
Systematic reviews, human case reports, and experimental animal studies have demonstrated the efficacy of intravenous lipid emulsion therapy in successfully reversing cardiac arrhythmias, cardiac arrest, and cardiac collapse seen with severe systemic local anesthetic toxicity. There are fewer data to support treatment of neurologic toxicities associated with local anesthetics.
Intravenous lipid emulsion 20% should be available whenever patients receive large doses of local anesthetics in operating rooms and emergency departments. Various dosing protocols have been published in the medical literature. Although the dosing protocols are based on low-level evidence, a lack of major adverse events makes lipid emulsion an appropriate therapy for treating cardiotoxic symptoms induced by local anesthetics.
静脉注射脂肪乳剂是否安全有效，可逆转和治疗局部麻醉毒性？
系统评价、人体病例报告和实验动物研究均表明，静脉注射脂肪乳剂治疗可成功逆转严重全身局部麻醉毒性引起的心律失常、心脏骤停和心脏停搏。关于治疗局部麻醉剂相关神经毒性的数据较少。
只要患者在手术室和急诊科接受大剂量局部麻醉剂，就应备有 20%的静脉注射脂肪乳剂。各种剂量方案已在医学文献中发表。尽管剂量方案基于低水平证据，但缺乏重大不良事件使得脂肪乳剂成为治疗局部麻醉剂引起的心脏毒性症状的合适治疗方法。
