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Systemic complications

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Toxic effects of local anaesthetics commonly occur because of:

  • excessive dosage
  • direct intravascular injection
  • use of agent in inflamed or vascular area
  • absorption that is too rapid
  • elimination that is too slow
  • idiopathic reaction to anaesthetic agent

Clinical feature include:

  • neural:
    • unease
    • anxiety
    • perioral tingling
    • tinnitus
    • euphoria
    • irritability
    • convulsions
    • coma
  • respiratory failure: central and peripheral actions
  • cardiovascular collapse:
    • bradycardia
    • vasodilatation
    • anaphylactic shock

Treatment targets the presenting complaint:

  • oxygenation
  • for convulsions, treat as for status epilepticus protocol
  • for cardiovascular collapse, full resuscitation is required including intubation, adrenaline and cardiac massage

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