Abstract
Abstract Introduction: Local Anesthetic Systemic Toxicity (LAST) is the most feared local anesthesia accident. As the cardiac arrest determined by LAST is mostly refractory to known resuscitation protocols, due local anesthetic blockade produced in the cardiac cells, the Lipid Emulsion (L.E) has been proved to be beneficial in resuscitating the cardiac arrest determined by local anesthetic. The aim for this presentation is to ease future studies on this topic, to ensure a starting point for next related research on LAST and LE mechanism of action. Method: Under genaral anesthesia we induced Local Anesthetic Systemic Toxicity to a rat model, by injecting Ropivacaine into the inferior vena cava. We monitored the cardiac activity of the subjects during the experiment. We used 4 groups of rats, control group- no intervention, lipid group- lipid emulsion was adminsitered, local anesthetic group- local anesthetic was administered and local anesthetic and lipid emulsion group- a dose of lipid emulsion was adminsitered before administering the local anesthetic. Results: After a few attemps to incannulate teh peripheral veins we tried the more complex approach of inferior vena cava, which ensured a secure access which allowed us to repetedly adminster the local anesthetic and the lipid emulsion. Conclusion: The presented experimental animal model of induced LAST and the protective effects of LE is one of the few described in the literature, is a reproducible model, feasible, simple, low cost and can be used as starting point in future LAST research.
Highlights
Local Anesthetic Systemic Toxicity (LAST) is the most feared local anesthesia accident
All local anesthetics (LA), except Lidocaine, are contraindicated for intravascular injection, due to their neurotoxic and cardio toxic effects [1]. This is the reason why the most feared complication which can occur during a regional anesthesia, regardless of the method of administration of LA. -single shot or a continuous technique, is Local Anesthetic Systemic Toxicity (LAST)
The aim of our study is to evaluate the prophylactic use of this drug in case of LAST, on an animal based model
Summary
Local Anesthetic Systemic Toxicity (LAST) is the most feared local anesthesia accident. As the cardiac arrest determined by LAST is mostly refractory to known resuscitation protocols, due local anesthetic blockade produced in the cardiac cells, the Lipid Emulsion (L.E) has been proved to be beneficial in resuscitating the cardiac arrest determined by local anesthetic The aim for this presentation is to ease future studies on this topic, to ensure a starting point for related research on LAST and LE mechanism of action. Method: Under genaral anesthesia we induced Local Anesthetic Systemic Toxicity to a rat model, by injecting Ropivacaine into the inferior vena cava. All LA, except Lidocaine, are contraindicated for intravascular injection, due to their neurotoxic and cardio toxic effects [1] This is the reason why the most feared complication which can occur during a regional anesthesia, regardless of the method of administration of LA. The occurrence of LAST is evaluated to be 0.03%, or 0.27 episodes per 1,000 peripheral nerve blocks. [3]
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