[Lipid emulsions for the treatment of systemic local anesthetic toxicity: Efficacy and limits].
Local anaesthetic toxicity always results from rapid and important increase in their plasma concentrations. Clinically, neurologic and cardiovascular symptoms may occur, especially life-threatening cardiac arrhythmias and cardiac depression. Resuscitating patients from cardiac toxicity was known as difficult, until the introduction of lipid emulsion therapy. From experimental data, at least two mechanisms of action can be proposed, a sink-effect and an improvement of cardiomyocyte metabolism. The present article is a mini-review of the current use of lipid emulsions for the treatment of local anaesthetic cardiac toxicity. The mechanisms of cardiac toxicity and those of lipid emulsion therapy are summarized, and the clinical experience of this therapy and its limits are presented.
Département d'anesthésie-douleur, pôle anesthésie-réanimation-douleur-urgences, GHU de Caremeau, Nîmes, France. guy.aya@chu-nimes.fr
A G M
AG
Aya
J
J
Ripart
M-A
MA
Sebbane
J-E
JE
de La Coussaye
D000779:Anesthetics, Local / Q000009:adverse effects*; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D006331:Heart Diseases / Q000139:chemically induced / Q000628:therapy; D006801:Humans
D000779:Anesthetics, Local; D005217:Fat Emulsions, Intravenous