title: Lipid emulsion improves Glasgow coma scale and decreases blood glucose level in the setting of acute non-local anesthetic drug poisoning--a randomized controlled trial.
abstract: BACKGROUND
  To date, no study has been performed to evaluate the antidotal effect of intravenous lipid emulsion on the poisoned patients' level of consciousness and routine metabolic profile tests in non-local anesthetic drug overdose.
  
  
  OBJECTIVE
  Our aim was to evaluate the effect of intravenous intralipid administration as an antidote on the poisoned patients' Glasgow Coma Scale (GCS), hemodynamic parameters, arterial blood gas analysis, and routine metabolic profile tests (i.e., urea, glucose, sodium, and potassium) in the setting of non-local anesthetic drug overdose.
  
  
  METHODS
  In this randomized controlled trial, a total of 30 patients with non-local anesthetic drug intoxication were enrolled and randomly assigned into case (n=15) and control (n=15) groups. In the case group, all patients received 10 cc/kg intralipid 10% infusion. The patients in the control group just received the supportive care. Patients' demographic and clinical characteristics and results of their laboratory tests were evaluated at presentation and 6 hours after that.
  
  
  RESULTS
  Mean age was 23 +/- 5 and 28 +/- 11 years in cases and controls, respectively. There were no significant statistical differences between these two groups regarding age, gender, elapsed time between intubation and extubation, and need for intubation and/or mechanical ventilation (p = 0.70 and p = 1.00, respectively). Also, systolic blood pressure, pulse rate, mean rate pressure product, respiratory rate, results of arterial blood gas analyses, serum sodium, potassium, urea, and creatinine on presentation and six hours later were not statistically significantly different between the two study groups. However, a significant difference was found between the two groups in terms of GCS difference (p = 0.048) and blood glucose six hours after presentation (p = 0.04).
  
  
  CONCLUSIONS
  In the setting of non-local anesthetic drug overdose, intravenous intralipid infusion can increase GCS and interestingly, decrease the blood glucose.
authors.affiliation: Department of Forensic Medicine and Toxicology, Tehran University of Medical Sciences, Hazrat Rasoul Akram Hospital, Tehran, Iran.
authors.forename: F
authors.initials: F
authors.lastname: Taftachi
authors.forename: H
authors.initials: H
authors.lastname: Sanaei-Zadeh
authors.forename: B
authors.initials: B
authors.lastname: Sepehrian
authors.forename: N
authors.initials: N
authors.lastname: Zamani
mesh_terms: D000328:Adult; D000931:Antidotes / Q000627:therapeutic use*; D001784:Blood Gas Analysis; D001786:Blood Glucose / Q000378:metabolism*; D003128:Coma / Q000139:chemically induced* / Q000188:drug therapy*; D062787:Drug Overdose; D064420:Drug-Related Side Effects and Adverse Reactions; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D005260:Female; D015600:Glasgow Coma Scale; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D011188:Potassium / Q000097:blood; D012121:Respiration, Artificial; D012964:Sodium / Q000097:blood; D014508:Urea / Q000097:blood; D055815:Young Adult
chemical_list: D000931:Antidotes; D001786:Blood Glucose; D005217:Fat Emulsions, Intravenous; D014508:Urea; D012964:Sodium; D011188:Potassium