This guideline can be used for the management of:
Intravenous lipid emulsion is a novel method for treating local anesthetic systemic toxicity that also shows promise as an effective antidote for other lipophilic drug poisonings.
Cardiovascular collapse is the most life-endangering complication of intravascular injection during regional anesthesia Local anasthetic systemic toxicity is generally considered to be resistant to conventional modes of resuscitation.
The ‘lipid sink’ phenomenon is the most widely accepted mechanism of action for lipids.The lipid emulsion infusion creates an expanded lipid phase, and the resulting equilibrium drives toxic drug from tissue to the aqueous plasma phase then to the lipid phase. This draws down the content of lipid-soluble local anaesthetics from within the cardiac tissue, thereby improving cardiac conduction, contractility, and coronary perfusion.
The Intralipid brand of fat emulsion is reserved soley for the emergency management of local anaesthetics inadvertently administered intravenously.
At PMH, the kit is located:
Give Lipid Emulsion 20% (IntraLipid brand of Fat Emulsion):
Lipids are given in addition to standard Cardio-Pulmonary Resuscitation.
Prompt and effective airway management must be implemented to prevent hypoxia and respiratory acidosis, which may potentiate local anaesthetic toxicity.
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