• Reg Anesth Pain Med · Mar 2010

    Historical Article

    Local anesthetic systemic toxicity: a historical perspective.

    • Kenneth Drasner.
    • University of California, San Francisco, CA 94110, USA. kdrasner@anesthesia.ucsf.edu
    • Reg Anesth Pain Med. 2010 Mar 1;35(2):162-6.

    AbstractThe most feared complication associated with the administration of local anesthetics is the profound and potentially lethal effect that these agents can have on cardiac conduction and function. This review traces the evolution of local anesthetic systemic toxicity beginning with the early deaths associated with the introduction of cocaine into clinical practice. The development of bupivacaine is discussed, with particular emphasis on the delayed recognition and acceptance of its inherent cardiotoxicity. Finally, the origins of lipid resuscitation are reviewed with respect to their theoretical foundation, as well as the confluence of events and experimental investigations that delivered this therapy into clinical practice.

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