Lipid emulsion therapy of local anesthetic systemic toxicity due to dental anesthesia
Journal of Dental Anesthesia and Pain Medicine
;
: 181-189, 2019.
Artículo
en Inglés
| WPRIM
| ID: wpr-764389
ABSTRACT
Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor , confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Arritmias Cardíacas
/
Inconsciencia
/
Sistema Cardiovascular
/
Sistema Nervioso Central
/
Incidencia
/
Prevalencia
/
Causalidad
/
Factores de Riesgo
/
Nutrición Parenteral
/
Mareo
Tipo de estudio:
Estudio diagnóstico
/
Estudio de etiología
/
Guía de Práctica Clínica
/
Estudio de incidencia
/
Estudio de prevalencia
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Humanos
/
Embarazo
Idioma:
Inglés
Revista:
Journal of Dental Anesthesia and Pain Medicine
Año:
2019
Tipo del documento:
Artículo
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