LAST

  • Exceeding the maximum safe dose (Bupivacaine 2mg/kg),
  • Lidocaine (5mg/kg)

Manifestations of Systemic Toxicity

  • Minor (Associated With Low Plasma Levels)
    • Perioral numbness
    • Facial tingling
    • Restlessness
    • Tinnitus
    • Metallic taste
    • Vertigo
    • Slurred speech
  • Major (Associated With High Plasma Levels)
    • Sudden loss of consciousness
    • Tonic-clonic seizures
    • Cardiovascular collapse
    • Cardiac arrest

LAST(CNS)

LAST (CVS)

  • Tachycardia & Hypertension
  • Hypotension
  • Wide QRS
  • VF
  • Cardiac arrest

MANAGEMENT

  • STOP
  • ACLS
  • SPECIFIC 20% INTRALIPID