SYSTEMIC TOXICITY BY LOCAL ANESTHETICS

Local anesthetics are drugs in widespread use and, although considered safe, can occasionally produce toxicity with alteration of the central nervous and cardiovascular system and potential life compromise.

The objective of this course is to facilitate the identification of the causes, the recognition of the clinical manifestations of systemic toxicity by local anesthetics from its earliest stages, and the therapeutic management of this adverse effect.

The clinical presentation is highly variable and encompasses a wide spectrum of symptoms mainly related to neurological and cardiovascular toxicity, including atypical presentations. Prevention is based on considering risk factors, carefully choosing the local anesthetic and dose, aspirating before injecting and fractionating the dose. Management of poisoning includes airway control, seizure control, maintenance of systemic circulation, and the use of intravenous lipid emulsion therapy.