Intravenous Fat Emulsion for Treatment of Local Anesthetic Systemic Toxicity: Best Practice and Review of the Literature.
| Autor: | Nedialkov AM; is a Certified Registered Nurse Anesthetist (CRNA) who practices at the University of Miami Hospital and Clinics and at Nicklaus Children's Hospital, both in Miami, Florida. Dr Nedialkov completed her doctor of nursing practice (DNP) at Barry University College of Nursing & Health Sciences, Miami Shores, Florida., Umadhay T; is the associate dean of academic affairs and associate professor of anesthesiology at Barry University College of Nursing & Health Sciences. He is also a practicing CRNA at Jackson Memorial Hospital in Miami, Florida., Valdes JA; is a clinical assistant professor of anesthesiology at Florida International University in the College of Nursing and Health Sciences, Miami, Florida. Dr Valdes received his bachelor of science in nursing from the University of Miami School of Nursing and Health Studies, Coral Cables, Florida; master of nurse anesthesia from the Mayo Clinic College of Medicine, Jacksonville, Florida; and his doctorate from the University of Miami, Coral Gables, Florida., Campbell Y; is an adjunct professor at Barry University in the College of Health Sciences and is the lead CRNA and student clinical coordinator at University of Miami School of Nursing and Health Studies. Dr Campbell received her bachelor of science in nursing at Florida Atlantic University, Boca Raton, Florida; master of science of anesthesia at Barry University, Miami Shores, Florida; and doctorate of nursing with specialization in anesthesiology at Barry University College of Nursing & Health Sciences. |
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| Jazyk: | angličtina |
| Zdroj: | AANA journal [AANA J] 2018 Aug; Vol. 86 (4), pp. 290-297. |
| Abstrakt: | Local anesthetic systemic toxicity (LAST), although rare, can be a fatal complication after regional anesthesia. The use of intravenous (IV) fat emulsion as a treatment of LAST is controversial among clinicians worldwide. This literature review aims to identify existing data supporting the use of IV lipids in the management of LAST and current best evidence-based practice by anesthesia providers during a LAST event. More than 120 articles resulted from a systematic literature search that was conducted using major search engines. Of those articles, 25 were included in this literature review. The safe use of IV lipids for the treatment of LAST is supported in the literature. Yet, there is still lack of awareness on lipid rescue therapy despite the significant evidence of its positive outcome. In the setting of local-anesthetic toxicity, lipid rescue should be considered first-line treatment. Intravenous lipids must be readily available in all institutions performing regional anesthesia. Education on their use, storage, and dosage is vital among anesthesia departments in the United States and worldwide. Competing Interests: The authors have declared no financial relationships with any commercial entity related to the content of this article. The authors did not discuss off-label use within the article. (Copyright© by the American Association of Nurse Anesthetists.) |
| Databáze: | MEDLINE |
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