Local Anaesthetic Toxicity is the unwanted systemic effects of local anaesthetic agents. These may be caused by inadvertent intravascular injection, or relative overdosage.
Sodium channels are present in many tissues therefore systemic local anaesthetics cause generalised tissue depression. Signs include: hypotension (direct cardiac depression, CVS centre depression and autonomic depression); bradycardia, heart block and asystole (depression of the cardiac conducting system); confusion and coma (CNS depression) and seizures (depression of inhibitory neuronal structures).
Management of toxicity is ABC, plus the management of the above signs, and may include: atropine, vasopressors, anticonvulsants, airway protection, respiratory support, and the management of cardiac arrest.
