Update on Local Anesthetic Toxicity, Prevention and Treatment During Regional Anesthesia in Infants and Children

J Pediatr Pharmacol Ther. 2021;26(5):445-454. doi: 10.5863/1551-6776-26.5.445. Epub 2021 Jun 28.


Local anesthetic agents play a key role in the treatment and prevention of pain in children. Although generally safe and effective, as with any pharmacologic agent, adverse effects may occur with the administration of these medications. Systemic absorption or inadvertent systemic injection during bolus dosing or continuous infusion can result in local anesthetic systemic toxicity with life-threatening neurological and cardiac complications. The following article reviews the pharmacology of local anesthetic agents, outlines previous reports of systemic toxicity during regional anesthesia, and discusses prevention and treatment algorithms.

Keywords: adverse drug effect; amide; ester; local anesthetic agent; local anesthetic systemic toxicity; pediatric; review.

Publication types

  • Review