The Association's 2010 laminate for management of local anaesthetic toxicity has been withdrawn.
Since 2010, there have been some subtle changes to the recommended management of local anaesthetic toxicity. Additionally, during that time, the Association has published its Quick Reference Handbook, which includes the most up to date treatment regime. The QRH version has therefore become the reference version.
Therefore, we now recommend that the relevant page (3-10) from the latest version of the Association's Quick Reference Handbook
should be kept in the local anaesthetic toxicity treatment box along with relevant drugs and equipment. The principal changes are to signal need for reduced adrenaline dosage and avoidance of vasopressin in LA toxicity, and slower administration of initial bolus of intralipid. Minor wording and formatting changes to aid clarity. (Note: Adrenaline dose has been modified to bring it into line with the recommendations of this review article, which is also referenced on our local anaesthetic toxicity page. This also brings us into line with the American ASRA guidance, which is itself backed up by this review article.)
The 2010 version should no longer be used.