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Article
Intravenous Fat Emulsion for Treatment of Local Anesthetic Systemic Toxicity; Best Practice and Review of the Literature
AANA Journal (2018)
  • Jorge Valdes, Florida International University
  • Ana M. Nedialkov, University of Miami Hospital and Clinics
  • Tony Umadhay, Barry University
  • Yasmine Campbell, Barry University
Abstract
Local anesthetic systemic toxicity (LAST), although rare, can be a fatal complication after regional anesthesia. The use of intravenous (IV) fat emulsion as a treatment of LAST is controversial among clinicians worldwide. This literature review aims to identify existing data supporting the use of IV lipids in the management of LAST and current best evidence-based practice by anesthesia providers during a LAST event. More than 120 articles resulted from a systematic literature search that was conducted using major search engines. Of those articles, 25 were included in this literature review. The safe use of IV lipids for the treatment of LAST is supported in the literature. Yet, there is still lack of awareness on lipid rescue therapy despite the significant evidence of its positive outcome. In the setting of local-anesthetic toxicity, lipid rescue should be considered first-line treatment. Intravenous lipids must be readily available in all institutions performing regional anesthesia. Education on their use, storage, and dosage is vital among anesthesia departments in the United States and worldwide. 
Keywords
  • Intravenous fat emulsion,
  • lipid emulsion,
  • lipid rescue,
  • lipid sink,
  • local anesthetic toxicity
Publication Date
August, 2018
Citation Information
Jorge Valdes, Ana M. Nedialkov, Tony Umadhay and Yasmine Campbell. "Intravenous Fat Emulsion for Treatment of Local Anesthetic Systemic Toxicity; Best Practice and Review of the Literature" AANA Journal (2018)
Available at: http://works.bepress.com/jorge-valdes/2/