Local anesthetic toxicity

Abstract

Local Anesthetics have been widely used in every hospitals and clinics. Its toxicity can lead to centralnervous system and cardiovascular disturbances with the clinical manifestations such as drowsiness, agitation, oreven seizure and unconsciousness, and fatal cardiac toxicity as severe arrhythmias and contractile dysfunction.Arrhythmias include conduction delay, ranging from bundle branch block and prolonged PR interval to ventriculartachycardia or fibrillation or even sinus arrest and asystole.

Severe local anesthetic toxicity is mechanistically complex. A review of chemistry and molecular actionsof local anesthetics and guidelines for the treatment of severe local anesthetic toxicity are discussed in this article.

Key words: Local anesthetic, Local anesthetic toxicity, Lidocaine, Bupivacaine, Levobupivacaine, Cardiovasculartoxicity