management of local anaesthetic systemic toxicity
Post on 03-May-2022
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MANAGEMENT OF LOCAL ANAESTHETIC SYSTEMIC TOXICITY
Ensure 100% oxygenation via mask or endotracheal tube Treat hypotension, bradycardia, arrhythmia Treat seizures with midazolam or thiopentone
Airway
Breathing Circulation
Call for help & get LIPID EMULSION
Activate cardiopulmonary
bypass teamStop injecting local
anaesthetic
STOP
>70kg Bolus-100ml over 2-3min
Infusion- 250ml over 15min
<70kg Bolus-1.5ml/kg over 2-3 min
Infusion- 0.25ml/kg/min
Unstable
Maximum 3 boluses Maximum dose-12ml/kg
After 5min
Avoid vasopressin, beta blockers, calcium channel blockers, local
anaesthetics, propofol
Use adrenaline in low doses (<1mcg/kg)
Monitor in ICU for upto 6h
INTRAVENOUS LIPID EMULSION THERAPY
Step 1
Step 2
Step 3
Stable Repeat bolus &
Double the infusion
CAUTION!
Intralipid
20% LIPID
EMULSION Paediatric
dose 1.5-2ml/kg
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