Local anaesthetic toxicity

Local anaesthetic systemic toxicity (LAST) is rare with fascia iliaca block. Direct intravascular injection can be avoided by direct visualisation. It is important to be aware of the signs and symptoms. These include:

  • Oral numbness / paraesthesia
  • Disinhibition, restlessness, confusion
  • Muscle twitching, tremor
  • Hypertension, tachycardia
  • Reduced consciousness, hypotension, seizures, arrhythmias

The AAGBI has a clear summary which may be useful to print out and keep in the department.

Management includes stopping the infiltration, resuscitation, control of seizures and intravenous lipid emulsion (intralipid).

You should be aware of the location and availability of intralipid in your department.

Collapse Comments

Very clear instructions. Best out there. A video would be great though

very good module on FICB, thanks

Abdal Hussain Butt June 14, 2019 at 4:03 pm

nice recap

Dr. Manikandan Manickam August 31, 2021 at 11:53 am

Good module

Useful revision.

Dr Dilshad Al-Sheikh September 2, 2022 at 8:53 am

very useful module indeed

Great summary and revision thanks

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