Systemic intoxication by local anesthetics

Abstract

The local anesthesics are defined as medicaments that block the generation and spread of impulses in excitable fabrics, from bony marrow, nervous roots, peripheral nerves or other excitable fabrics as cardiac muscle, smooth muscle and brain. The systemic intoxication takes place due to the plasmatic concentrations raised after high doses or the intravenous inadvertent administration. The increasing use of technologies of anesthesia locorregional forces to bear in mind the systemic intoxication for local anesthesics as an anesthesic complication of low incident, but high morbi-mortality, beside constituting one of the more frequent reasons of cardiorespiratory unemployment of anesthesic origin. The clinical presentation of this complication is very variable and includes a great spectrum of symptoms related principally to the neurological and cardiovascular toxicity. Though infrequent, the reactions can be very serious, and to result in irreversible hurt or death of the patient. The prevention seems to have diminished the poisoning of the local anesthesics and is more effective than the treatment. The managing is based on measures of resuscitation cardiopulmonar advanced, the pharmacological treatment and the precocious employment of the lipid emulsions. I present a case of systemic intoxication using lidocaine simply as anesthesic local only one during the accomplishment of blockade of peripheral nerve in elective surgery.