Local anesthetic systemic toxicity

Aesthet Surg J. 2014 Sep;34(7):1111-9. doi: 10.1177/1090820X14543102. Epub 2014 Jul 15.


Local anesthetic systemic toxicity (LAST) is a rare yet devastating complication from the administration of local anesthesia. The ability to recognize and treat LAST is critical for clinicians who administer these drugs. The authors reviewed the literature on the mechanism, treatment, and prevention of LAST, with the goal of proposing a practical method for its management.

Keywords: acute pain; ambulatory surgery; bupivacaine toxicity; lipid emulsion; local anesthetic toxicity.

Publication types

  • Review

MeSH terms

  • Anesthesia, Local / adverse effects*
  • Anesthesia, Local / methods
  • Anesthesia, Local / mortality
  • Anesthetics, Local / adverse effects*
  • Animals
  • Humans
  • Patient Safety
  • Poisoning / diagnosis
  • Poisoning / etiology
  • Poisoning / mortality
  • Poisoning / prevention & control
  • Poisoning / therapy
  • Prognosis
  • Risk Assessment
  • Risk Factors


  • Anesthetics, Local