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Lipid emulsion treatment for local anesthetic systemic toxicity in pediatric patients: A systematic review.
Lee, Soo Hee; Kim, Sunmin; Sohn, Ju-Tae.
Afiliación
  • Lee SH; Department of Anesthesiology and Pain Medicine, Gyeongsang National University Changwon Hospital 11, Gyeongsangnam-do, Republic of Korea.
  • Kim S; Department of Anesthesiology and Pain Medicine, Gyeongsang National University College of Medicine, Gyeongsangnam-do, Republic of Korea.
  • Sohn JT; Institute of Medical Science, Gyeongsang National University, Jinju-si, Republic of Korea.
Medicine (Baltimore) ; 103(11): e37534, 2024 Mar 15.
Article en En | MEDLINE | ID: mdl-38489714
ABSTRACT

BACKGROUND:

Local anesthetic systemic toxicity (LAST) is rare, but fatal; the current widely used treatment is lipid emulsion (LE). The goal of this study was to analyze and review case reports on LE treatment for LAST in pediatric patients.

METHODS:

We performed a systematic review using case reports on LE treatment for LAST in pediatric patients, searching PubMed and Scopus databases to March 2023 using the following keywords ("local anesthetic toxicity" OR "local anesthetic systemic toxicity" OR LAST") AND ("newborn" OR "infant" OR "child" OR "children" OR "adolescent" OR "pediatric") AND ("lipid emulsion" OR "Intralipid").

RESULTS:

Our search yielded 21 cases, revealing that nearly 43% patients with LAST were less than 1 year old, and most cases were caused by bupivacaine (approximately 67% cases). "Inadvertent intravascular injection" by anesthesiologists and "overdose of local anesthetics" mainly by surgeons were responsible for 52% and 24% cases of LAST, respectively. LAST occurred in the awake state (52%) and under general anesthesia (48%), mainly causing seizures and arrhythmia, respectively. Approximately 55% of patients received LE treatment in <10 minutes after LAST, mainly improving cardiovascular symptoms. A 20% LE (1.5 mL/kg) dose followed by 0.25 mL/kg/minutes dose was frequently used. LE and anticonvulsants were mainly used in the awake state, whereas LE with or without vasopressors was mainly used under general anesthesia. LE treatment led to full recovery from LAST in 20 cases; however, 1 patient died due to underlying disease.

CONCLUSION:

Consequently, our findings reveal that LE is effective in treating pediatric LAST.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Emulsiones Grasas Intravenosas / Anestésicos Locales Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: Medicine (Baltimore) Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Emulsiones Grasas Intravenosas / Anestésicos Locales Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: Medicine (Baltimore) Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos