背景 局部麻醉药（local anesthetic, LA）急性全身毒性反应（local anesthetic systemtic toxicity, LAST）指LA误入血管内或单位时间内吸收入血的LA剂量过大引起的毒性反应，主要表现为中枢神经系统毒性和心血管功能障碍。随着新技术如超声引导下神经阻滞的开展和连续输注导管的引进，LA误入血管的发生率降低，但若LA误入血管，引起的全身反应往往是致命的，需引起重视。1998年Weinberg建立的动物模型中脂肪乳剂（lipid emulsion, LE）对LAST发挥有效治疗，其复苏疗效得到认同。 目的 探讨LE治疗LAST的机制和临床应用进展。 内容 综述LE治疗LAST的机制、适应证、剂量及复苏的注意事项等。 趋向 LE可能为临床治疗LAST提供有效的预防及治疗措施。
Background Local anesthetic systemic toxicity(LAST） caused by local anesthetic(LA) can led to severe neurotoxicity and cardiovascular dysfunction consequent to unintended intravascular injection or excessive absorption of drugs within a short time. In spite of the dropping incidence of unintended intravascular injection with the help of some new technologies like ultrasound-guided nerve blockade and continuous infusion catheter, when it happens, its effects may be devastating. In 1998, an animal study made by Weinberg indicated that lipid emulsion(LE) can be used to treat LAST. Since then there have been many more such reports supporting the hypothesis. Objective To discuss the mechanism of how LE works and clinical application of LE on treating LAST. Content The mechanism of how LE works, indications, dosage and some notes about resuscitation. Trend Application of LE may be an effective measure to prevent and treat LAST.
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