Local Anesthetics, Local Anesthetic Systemic Toxicity (LAST), and Liposomal Bupivacaine

Clin Sports Med. 2022 Apr;41(2):303-315. doi: 10.1016/j.csm.2021.12.001.

Abstract

Local anesthetics have played a vital role in the multimodal analgesia approach to patient care by decreasing the use of perioperative opioids, enhancing patient satisfaction, decreasing the incidence of postoperative nausea and vomiting, decreasing the length of hospital stay, and reducing the risk of chronic postsurgical pain. The opioid-reduced anesthetic management for perioperative analgesia has been largely successful with the use of local anesthetics during procedures such as peripheral nerve blocks and neuraxial analgesia. It is important that practitioners who use local anesthetics are aware of the risk factors, presentation, and management of local anesthetic systemic toxicity (LAST).

Keywords: Acute pain; LAST; Liposomal bupivacaine; Local anesthetic toxicity; Local anesthetics; Regional anesthesiology.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid
  • Anesthetics, Local* / adverse effects
  • Bupivacaine / adverse effects
  • Humans
  • Pain Management / methods
  • Pain, Postoperative* / chemically induced
  • Pain, Postoperative* / drug therapy

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Bupivacaine