Local Anesthesia Toxicity and Lipid Rescue

Regional anesthesia as a treatment modality for the control of surgical pain has been in practice since the late 1880s with the introduction of cocaine. The use of lipid emulsion therapy as an emerging treatment for the rare but life-threatening development of local anesthesia systemic toxicity (LAST) has been in the animal literature for approximately 20 years, and case reports have documented successful results with this treatment in humans. The perianesthesia nurse has a significant role in the assessment, communication with the anesthesia care provider, and the emergent management of the patient experiencing LAST. Using a fictitious case study of a patient with LAST, the conduction of sensory information will be reviewed. The pharmacologic characteristics of local anesthetics will be presented, and the evidence-based practice recommendations for the prevention, monitoring, and treatment will be provided.