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Local Anesthetic Systemic Toxicity in Obstetrics (LAST)

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Local Anesthetic SensitivitySeizuresArrhythmiasBradycardiaHypotensionShockReduced Cardiac OutputAvoid AcidosisAvoid HypoxiaAvoid HypercarbiaAvoid Hypoventilation

Pathophysiology

Local anesthetic systemic toxicity (LAST) in the parturient begins the same way it does anywhere else — a plasma level spike that blocks voltage-gated sodium channels in brain and heart — but...

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