Local anaesthetic toxicity

T41.3

Airway management:

  • Ventilate with 100% oxygen.

Seizure suppression:

  • Diazepam, IV, 10 mg.

Cardiopulmonary resuscitation may be required.

  • Reduce individual adrenaline (epinephrine) doses to < 1 mcg/kg.

LoEIII [27]

  • Lipid emulsion (20%), IV, 1.5 mL/kg over 1 min, then continuous infusion 0.25 mL/kg/min.
    • Repeat bolus 1–2 times for persistent cardiovascular collapse.
    • Double infusion rate to 0.5 mL/kg/min if BP remains low.
    • Continue infusion for at least 10 minutes after cardiovascular stability attained.
    • Recommended upper limit: approximately 10 mL/kg lipid emulsion over the first 30 minutes.

LoEIII [28]