Cardiac Arrest From Local Anesthetic Systemic Toxicity (LAST): A Rare Complication of Ultrasound-Guided Sternal Hematoma Block.

Local anesthetic systemic toxicity (LAST) is a rare but serious complication of ultrasound-guided nerve and hematoma blocks, affecting the cardiovascular and central nervous systems. Clinicians performing these procedures should be aware of the possibility of LAST, recognize the early signs and symptoms, and understand the current accepted treatment. We present a case of cardiovascular collapse caused by LAST following an ultrasound-guided sternal hematoma block and discuss potential systems-based improvements to enhance the management and prevention of this life-threatening emergency. Thoracic blocks may pose a higher risk of LAST because of the close proximity to the heart, and we recommend using lower doses of local anesthetic when performing these blocks.