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  Chapter 120 Severe local anaesthetic toxicity 
Regimen for intravenous lipid emulsion | Introduction | Signs of severe toxicity | Immediate management | Management in cardiac arrest | Management without cardiac arrest | Follow-up | References | Last reviewed
 
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Management in cardiac arrest

  • Commence cardiopulmonary resuscitation (CPR)  
  • Manage arrhythmias, recognising that the arrhythmias may be very refractory to treatment
  • Consider the use of cardiopulmonary bypass if available
  • GIVE INTRAVENOUS INTRALIPID EMULSION (IV intralipid emulsion regimen flow chart)
  • Follow regimen for intravenous lipid emulsion as above
  • Continue CPR throughout treatment with lipid emulsion
  • Recovery from LA-induced cardiac arrest may take >1 hour
  • Propofol is not a suitable substitute for lipid emulsion
  • Lidocaine should not be used as an anti-arrhythmic therapy

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Immediate management | Page 5 of 9 | Management without cardiac arrest