Guidelines and the adoption of ‘lipid rescue’ therapy for local anaesthetic toxicity

@article{Picard2009GuidelinesAT,
  title={Guidelines and the adoption of ‘lipid rescue’ therapy for local anaesthetic toxicity},
  author={John Picard and Stephen Ward and Ralph Zumpe and Tim Meek and J Barlow and William A. Harrop-Griffiths},
  journal={Anaesthesia},
  year={2009},
  volume={64}
}
Gathering evidence from animal experiments, an editorial in this journal and published human case reports culminated in the Association of Anaesthetists of Great Britain and Ireland recommending in August 2007 that lipid emulsion be immediately available to all patients given potentially cardiotoxic doses of local anaesthetic drugs. This development offered an opportunity to track the adoption of an innovation by anaesthetists in the UK and to gauge the effects of guidelines. Two surveys, each… 

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[Lipid emulsion therapy for local anaesthetic toxicity. (LipidRescue)].

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...

References

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Availability of lipid emulsion in obstetric anaesthesia in the UK: a national questionnaire survey

Around three‐quarters of labour wards in the UK either have lipid emulsion available or plan to obtain it, and around two‐thirds had a recommended dose regimen for its administration.

Lipid emulsion to treat overdose of local anaesthetic: the gift of the glob

Fat is bad for you. It may make our food appetising, but is widely consumed in gross surfeit. In excess, fat harms our patients and impedes any anaesthetic manoeuvre. But fat may also be clinically

Lipid Emulsion Infusion Rescues Dogs From Bupivacaine-Induced Cardiac Toxicity

It was found that infusing a lipid emulsion during resuscitation from bupivacaine-induced cardiac toxicity substantially improved hemodynamics, pmO2, and pHm and increased survival in dogs.

Pretreatment or Resuscitation with a Lipid Infusion Shifts the Dose‐Response to Bupivacaine‐induced Asystole in Rats

Lipid infusion shifts the dose‐response to bupivacaine‐induced asystole in rats and suggests a potential application for lipid infusion in treating cardiotoxicity resulting from bupvacaine.

Successful resuscitation of a patient with ropivacaine‐induced asystole after axillary plexus block using lipid infusion *

This case shows that lipid infusion may have a beneficial role in cases of local anaesthetic toxicity when conventional resuscitation has been unsuccessful, and it is believed the cardiovascular collapse was secondary to ropivacaine absorption following the accidental overdose.

Successful use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest.

The patient was a 58-yr-old, 82-kg, 170-cm male who presented for arthroscopic repair of a torn rotator cuff in the right shoulder who was considered by his cardiologist to be stable on medical therapy and plans were being made to institute cardiopulmonary bypass.

Principles of successful sample surveys.

The arcane subject of modeling binary data using population analysis, a technique that determines the response of the typical individual, as well as interand intraindividual variability, is explored in this issue of the Journal.

Diffusion of innovations

Upon returning to the U.S., author Singhal’s Google search revealed the following: in January 2001, the impeachment trial against President Estrada was halted by senators who supported him and the government fell without a shot being fired.