Aliases:
LA toxicity
Local anaesthetic overdose
LA overdose
Local Anaesthetic Systemic Toxicity
Local Anesthetic Systemic Toxicity
LAST
Local anaesthetic toxicity
Local anesthetic toxicity
Local anaesthesia toxicity

Topic aliases are alternate phrasings for a particular topic.


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Use the least dose of LA necessary to achieve the desired extent and duration of block.

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Cardiovascular signs (often the only manifestation of
severe LAST)
- Initially may be hyperdynamic (hypertension, tachycardia, ventricular arrhythmias), then
- Progressive hypotension
- Conduction block, bradycardia or asystole
- Ventricular arrhythmia (ventricular tachycardia, Torsades de Pointes, ventricular fibrillation)
www.asra.com/checklist-fo...

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Central nervous system signs (may be subtle or absent)
- Excitation (agitation, confusion, muscle twitching, seizure)
- Depression (drowsiness, obtundation, coma or
apnea)
- Non-specific (metallic taste, circumoral numbness, diplopia, tinnitus, dizziness)
www.asra.com/checklist-fo...

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Consider LAST in any patient with altered mental status, neurological symptoms or cardiovascular instability after a regional anesthetic. www.asra.com/checklist-fo...

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Post LAST events to lipidrescue.org and use of intralipid to lipidregistry.org

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ASRA have created a checklist for the management of local anaesthetic systemic toxicity (LAST) at www.asra.com/checklist-fo...

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