Windows into Related Disciplines
Anaesthesiology Local anaesthetic systemic toxicity: A critical consideration for OR nurses 

Authors

  • Sunti Barahi

DOI:

https://doi.org/10.5737/ornac14501

Abstract

Local anaesthetics (LAs) are medications administered by many types of healthcare workers, including anaesthesiologists, dentists, surgeons, emergency department physicians, and nurses. Local anaesthetic systemic toxicity (LAST) refers to a spectrum of clinical manifestations arising from excessive absorption of LAs. Although reported incidences of major LAST events is very low (0.04–1.8/1000 for nerve blocks), likely due to increased awareness and preventive protocols, their potential to cause life-threatening cardiovascular and neurological complications necessitates vigilance. Understanding the toxic thresholds of different LAs (Table 1) and recognizing early symptoms is crucial for timely intervention and effective management.

Author Biography

Sunti Barahi

IWK Health Centre, Halifax, Nova Scotia
Department of Anaesthesiology, Dalhousie University, Halifax, Nova Scotia

References

Anesthesia Considerations. (n.d.) Local anesthetic toxicity. https://www.anesthesiaconsiderations.com/local-anesthetic-toxicity

Braehler, M. (2020). Local anesthetic systemic toxicity. Pain Management Education at University of California at San Francisco. https://pain.ucsf.edu/local-anesthetics/local-anesthetic-systemic-toxicity-last

Gadsden, J. (2012). Chapter 2. Local anesthetics: Clinical pharmacology and rational selection. In A. Hadzic (Ed.), Hadzic’s peripheral nerve blocks and anatomy for ultrasound-guided regional anesthesia (2nd ed.). The McGraw-Hill Companies. https://accessanesthesiology.mhmedical.com/content.aspx?bookid=518&sectionid=41534288

Neal, J. M., Neal, E. J., & Weinberg, G. L. (2021). American Society of Regional Anesthesia and pain medicine local anesthetic systemic toxicity checklist: 2020 version. Regional Anesthesia and Pain Medicine, 46(1), 81–82. https://doi.org/10.1136/rapm-2020-101986

Warren, L., & Pak, A. (n.d.). Local anesthetic systemic toxicity. UpToDate Inc. https://www.uptodate.com/contents/local-anesthetic-systemic-toxicity

Published

2025-05-15

How to Cite

Barahi, S. (2025). Windows into Related Disciplines
Anaesthesiology Local anaesthetic systemic toxicity: A critical consideration for OR nurses . Operating Room Nurses Association of Canada Journal, 42(1), 21–22. https://doi.org/10.5737/ornac14501

Issue

Section

ORNAC Network