Use of lipid emulsion as an antidote in the treatment of intoxication by local anesthetics and other lipophilic drugs

Abstract

Local anesthetics are commonly used in surgical procedures, they are able to promote a reversible blockade of nerve conduction, with loss of sensation in circumscribed area of the body without changing the individual's level of consciousness. The aim of this study was to review the literature that can compose the body of evidence on efficacy and safety of Lipid Emulsion (ELI) for use as an antidote in the treatment of intoxication by local anesthetics and other lipofílicos. Trata is a review drugs literature that we used the Fat Emulsions terms Intravenous AND Antidotes for the search in the following databases: Pubmed; Cochrane Library and Trip Database and were raised studies found in these bases until November 2015. The review conducted showed that the use of ELI as an antidote seems to be a possible alternative for the treatment of poisoning caused by local anesthetics and other lipophilic drugs. Recently the ELI have been used also as an antidote against cardiovascular collapse induced by bupivacaine and other local anesthetics lipophilic. Early studies reported more frequently the use of Intralipid®, intravenously, which is sold in formulations containing soybean oil at different concentrations (10, 20 or 30%) in admixture with other lipids and phospholipids. The effects produced by Intralipid® have also been attributed to other lipid emulsions of formulations composed of different extracts of oils. However, current evidence supporting this use are scarce and uncertain, pointing to the need for additional studies. With respect to this fact, recently the American Academy of Clinical Toxicology.