hypoxia differentiates between LAST and methemoglobinemia

Lipid emulsion is used for the management of local anesthetic systemic toxicity (LAST), a rare complication typically occurring within minutes of local anesthetic administration, although it can occasionally manifest after 1 h. LAST primarily affects the cardiovascular and central nervous systems and can manifest with altered mentation, seizures, arrhythmias, and hemodynamic instability. Hypoxia is not a typical presenting symptom.12345

Footnotes

  1. SEEK Questionnaires ↩

  2. Long B, Chavez S, Gottlieb M, et al. Local anesthetic systemic toxicity: a narrative review for emergency clinicians. Am J Emerg Med. 2022;59:42-48. PubMed ↩

  3. Iolascon A, Andolfo I, Russo R, et al. Summary of joint European Hematology Association (EHA) and EuroBloodNet recommendations on diagnosis and treatment of methemoglobinemia. Hemasphere. 2021;5(12):e660. PubMed ↩

  4. Iolascon A, Bianchi P, Andolfo I, et al; SWG of red cell and iron of EHA and EuroBloodNet. Recommendations for diagnosis and treatment of methemoglobinemia. Am J Hematol. 2021;96(12):1666-1678. PubMed ↩

  5. Hendry-Hofer TB, Ng PC, Witeof AE, et al. A review on ingested cyanide: risks, clinical presentation, diagnostics, and treatment challenges. J Med Toxicol. 2019;15(2):128-133. PubMed ↩