Local Anesthetic Toxicity

Local anesthetics are commonly used in most medical and dental practice. While adverse effects are rare, the rising prevalence of local anesthetics in practice has resulted in a greater incidence of local anesthetic toxicity. From minor symptoms to major cardiac or central nervous system (CNS) effects, local anesthetic systemic toxicity (LAST) is an important consequence of which to be aware. Systemic toxicity was originally associated with seizures and respiratory failure. However, in the 1970s, cardiac effects were also recognized, as bupivacaine-associated fatal cardiac toxicity was discovered in healthy adults. This article reviews the mechanisms, frequency, clinical characteristics, treatment, and prevention of LAST.[1][2][3]