Local anesthetic systemic toxicity (LAST)

Stop local anesthetic; secure airway/oxygenation
Treat seizures promptly
IV lipid emulsion is specific rescue therapy
Use modified ACLS for arrhythmia/shock
Avoid large epinephrine doses and vasopressin
Refractory cardiovascular collapse → ECMO consideration

Use at a glance

Stop local anesthetic; secure airway/oxygenation

Escalation / refractory disease

Refractory cardiovascular collapse → ECMO consideration

Treatment options

IV lipid emulsion is specific rescue therapy
Use modified ACLS for arrhythmia/shock

Safety / pitfalls

Treat seizures promptly
Avoid large epinephrine doses and vasopressin

Self-check

What should be stopped immediately in Local anesthetic systemic toxicity (LAST)?
local anesthetic; secure airway/oxygenation.
Which patients should be treated promptly for Local anesthetic systemic toxicity (LAST)?
seizures.

Drugs used for this (1)

IV lipid emulsion ballicule — decagon mechanism diagram — IV lipid emulsion — off-label

All clinical uses · Open the interactive console ↗