You're Toxic!
Excess plasma concentrations of local anesthetics will result in this.
Local Anesthetic Systemic Toxicity (LAST)
Local anesthetics block these channels.
Sodium channels
This determines the onset of local anesthetics.
pKa
For surgical procedures involving the shoulder and the proximal humerus.
Provides innervation to the medial side of the lower leg.
Femoral nerve
Transtracheal block
This is the maximum safe dose of Lidocaine.
300 mg
These nerve fibers are blocked early and block pain & temperature.
C fibers
This determines the duration of action of local anesthetics.
Protein binding
Nerve missed during an interscalene block.
Ulnar nerve
This block preserves quadriceps strength.
Adductor canal block
Targets the subcostal, ilioinguinal, and iliohypogastric nerves.
Transversus abdominus plane block (TAP)
This is the most cardiotoxic local anesthetic.
Bupivacaine
Local anesthetics have pKa higher than 7.6 making it this.
A weak base
This determines the potency of local anesthetics.
Lipid solubility
For surgical procedures below the elbow.
Supraclavicular block
This nerve can be approached anteriorly, posteriorly or within the popliteal fossa.
Blocks the lateral and medial pectoral nerves.
PECS I block
This is the pharmacological management of LAST.
20% intralipid therapy
The 2 classes of local anesthetics.
Local anesthetics have the highest level of systemic absorption when administered this way.
Intravenous
Nerve spared during infraclavicular block.
Intercostobrachial nerve
The 2 deep nerves of the ankle block.
Posterior tibial & deep peroneal
Ipsilateral myosis, ptosis, and anhidrosis.
Horner's syndrome
This is the dose of 20% intralipid therapy for LAST.
1.5 mL/kg followed by 0.25 mL/kg infusion
Allergies to local anesthetics are often a result of this metabolite.
Para-aminobenzoic acid (PABA)
Local anesthetics have the lowest level of systemic absorption when administered this way.
Subcutaneous
For surgical procedures distal to the elbow.
Axillary block
The 3 superficial nerves of the ankle block.
Superficial peroneal, sural, and saphenous
This nerve is spared during an axillary block.
Musculocutaneous nerve