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Extra info for Clinical use of local anesthetics
Introduction Surgical procedures under local anesthesia provide unique advantages. They are associated with less patient anxiety antecedent with the use of general or major regional anesthesia. It is also associated with quicker recovery, less day care recovery room stay and earlier returns to work. It is therefore not surprising that there is considerable interest both among patients and surgeons. The impetus for this has been to maximize anesthetic and postoperative resources by increasing patient turnover in the operating room and discharging patients more efficiently on the same day.
Incisional hernioplasty with Mersilene. Surg Gynecol Obstet 1991; 172: 129 – 137  Acevedo A. Multisacularidad de las eventraciones de la línea media. Cuaderno de resúmenes del LXXVII Congreso Chileno de Cirugía, Pucón, 2004  Acevedo A, Viterbo A, Bravo J, Dellepiane V. Eventraciones, cirugía ambulatoria con anestesia local. Rev Chil Cir 2006; 58: 354 – 358  Acevedo A, Lombardi J, Leon J, López J, Schultz E, Dellepiane V. Eventraciones. Reconstrucción plástica xe la línea alba mediante doble sutura invaginante isotensional (DSII).
Although the exact cause and management of LAST (particularly local anesthetic cardiotoxicity) is unclear, there have been some recommendations. Current data suggests that the LAST cardiotoxicity occurs primarily at sodium channels. Lipid emulsion is a reasonably well-tolerated and effective treatment, and there may be qualitative differences in cardiotoxicity caused by low and high-potency local anesthetics (Wolfe and Butterworth, 2011). Treatment is mostly supportive and includes ventilation; oxygenation, and chest compressions, lipid emulsion therapy should be a primary modality in the treatment of cardiovascular LAST.