Intoxication local anaesthetics : intravenous use of lipid emulsion as antidote

Abstract

The local anesthetic technique when performed with a quality product results in the abolition of autonom ic and sensory motors functions . The c ardiotoxicity caused by local anesthetics is a hard condition to manage, given traditional therapies, which are quite limited. Thus, it is crucial to evaluate the clinical fea sibility of using Lipid Emulsion (LE) intravenously in the treatment of poisoning by local anesthetics, because this may be a viable therapeutic option as re scue procedure. Currently , in the hypothetical level that the LE acts by three distinct mechanisms of action: Formation of a "Lipid Trap," transport of fatty acids to the mitochondria of the cardiac muscle tissue and a positive inotropic effect in the myocardium. One can derive that its clinical utility in cardiovascular collapse is higher in the first moments of intoxication AL, before installation of the situation of hypoxia and/or metabolic acidosis. In this context the use of LE as therapy for acute intoxication AL appears as a safe and effective alternative, with a very low risk profile and with a g ood degree documented evidence of benefit. Thus, it is important for the surgical team's the knowledge of this therapy in the cardiotoxicity management caused by acute intoxication for AL.