From the Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York City, New York.
University of Maryland School of Medicine, Baltimore, Maryland.
A A Pract. 2020 Nov;14(13):e01336. doi: 10.1213/XAA.0000000000001336.
The use of local anesthetics for improved pain management is well established. However, significant morbidity may be caused by local anesthetic systemic toxicity (LAST) from inadvertent intravascular injection or excessive dosing of local anesthetics. Despite incomplete understanding of the mechanism of action of intravenous lipid emulsions (ILE), their use has become a first-line therapy for treating LAST. We present a case report of LAST, successfully treated with ILE with a secondary effect of complete reversal of a successful peripheral nerve block as quickly as the LAST symptoms resolved.
局部麻醉剂在改善疼痛管理方面的应用已得到充分证实。然而,由于局部麻醉剂的意外血管内注射或过量给药,可能会导致严重的发病率,即全身毒性(LAST)。尽管对静脉内脂肪乳剂(ILE)作用机制的了解并不完全,但它们的使用已成为治疗 LAST 的一线治疗方法。我们报告了一例 LAST 病例,成功地使用 ILE 治疗,其次效是随着 LAST 症状的缓解,成功的外周神经阻滞也迅速完全逆转。