ReviewLocal and regional anesthesia2018
Local anesthetic systemic toxicity: current perspectives.
Review in Local and regional anesthesia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 187 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy of Postoperative Pain Control Between Transarticular VS Periartiucular Multimodal Drug Infiltration in Total Hip Arthroplasty: Double-blinded Randomized Control Trial
Analgesic Comparison of Pericapsular Nerve Group (PENG) Block and Lateral Femoral Cutaneous Nerve (LFCN) Block to Fascia Iliaca Compartment Block (FICB) in Patients Undergoing Primary Total Hip Arthroplasty (THA).
Comparison Between the Effects of Lidocaine Prilocaine Cream and Lidocaine Injection on Reduction of Perineal Pain During Episiotomy and Perineum Repair in Vaginal Delivery: Randomized Control Trial
Effectiveness Of Modified-Thoracoabdominal Nerve Block Perichondrial Approach (M-TAPA) Post-Operative Analgesia Compared To Intravenous Opioids In Laparoscopic Cholecystectomy Patients
Who cites it
187 citing papers in PubMed, 3 syntheses or guidelines pooled it, 480 citations in OpenAlex.
- Regional anaesthesia modalities for primary total hip arthroplasty: a systematic review and component network meta-analysis.British journal of anaesthesia · 2025Pooled it
- The analgesic efficacy of quadratus lumborum block in caesarean delivery: a meta-analysis and trial sequential analysis.Journal of anesthesia · 2020Pooled it
- Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults.Anaesthesia · 2020Guideline
- Lidocaine combined with low-dose esketamine for movement-evoked pain after hepatectomy: a double-blind randomised controlled trial.Anaesthesia · 2026Trial
- Effects of transversus abdominis and erector spinae plane blocks on postoperative pain control and postpartum depression after cesarean section: a randomized prospective study.Turkish journal of medical sciences · 2026Trial
- Combining ropivacaine transversus abdominis plane block with intravenous lidocaine infusion in adults undergoing colorectal cancer surgery: an open-label, dose-escalation exploratory trial.BMC anesthesiology · 2025Trial
- Trial
- Dexamethasone as an adjuvant with ropivacaine in thoracoscopy guided thoracic paravertebral block for postoperative analgesia in thoracic surgery.Scientific reports · 2025Trial
- Quadratus lumborum block for total abdominal hysterectomy: a double-blind, randomized, controlled trial.Turkish journal of medical sciences · 2025Trial
- The value of local dexmedetomidine as an adjuvant to ultrasound-guided wide awake local anesthesia no tourniquet (WALANT) in flexor tendon repair surgeries: a randomized controlled trial.BMC anesthesiology · 2024Trial
- Ultrasound-Guided Axillary Brachial Plexus Block for the Management of Graft Site Pain During Dressing Change in the Burn-Injured Patient: A Randomized Control Trial.Journal of burn care & research : official publication of the American Burn Association · 2023Trial
- Ultrasound-guided bilateral modified-thoracoabdominal nerve block through a perichondrial approach (M-TAPA) in patients undergoing laparoscopic cholecystectomy: a randomized double-blind controlled trial.BMC anesthesiology · 2022Trial
- Unilateral transversus abdominis plane block and port-site infiltration : Comparison of postoperative analgesic efficacy in laparoscopic cholecystectomy.Der Anaesthesist · 2020Trial
- Local Anaesthetic Dosing and Toxicity Knowledge in Australian Emergency Departments: A Multicentre Cross-Sectional Survey.Emergency medicine Australasia : EMA · 2026Article
- Targeting of tripartite neuron-cancer-immune cell crosstalk augments response to chemotherapy and immunotherapy.Cell reports. Medicine · 2026Article
- Local anesthetic selection for spine and large joint radiofrequency ablation: a practical review for the musculoskeletal radiologist.Skeletal radiology · 2026Review
- Case Report: Lidocaine Toxicity Presenting with Focal Neurologic Findings.Clinical practice and cases in emergency medicine · 2026Article
- Molecular Mechanisms of Local Anesthetic Toxicity: From Ion Channel Dysregulation to Mitochondrial Dysfunction and Tissue-Specific Injury.International journal of molecular sciences · 2026Review
- Sudden neonatal death following circumcision associated with bupivacaine-induced Local Anesthetic Systemic Toxicity (LAST): a forensic case report.Forensic science, medicine, and pathology · 2026Article
- Emergency Preparedness for Local Anesthetic Systemic Toxicity in Dental Practice: Dentists' Knowledge, Awareness, and Institutional Availability of Lipid Emulsion Therapy.Healthcare (Basel, Switzerland) · 2026Article
127 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Local anesthetic systemic toxicity (LAST) is a life-threatening adverse event that may occur after the administration of local anesthetic drugs through a variety of routes. Increasing use of local anesthetic techniques in various healthcare settings makes contemporary understanding of LAST highly relevant. Recent data have demonstrated that the underlying mechanisms of LAST are multifactorial, with diverse cellular effects in the central nervous system and cardiovascular system. Although neurological presentation is most common, LAST often presents atypically, and one-fifth of the reported cases present with isolated cardiovascular disturbance. There are several risk factors that are associated with the drug used and the administration technique. LAST can be mitigated by targeting the modifiable risk factors, including the use of ultrasound for regional anesthetic techniques and restricting drug dosage. There have been significant developments in our understanding of LAST treatment. Key advances include early administration of lipid emulsion therapy, prompt seizure management, and careful selection of cardiovascular supportive pharmacotherapy. Cognizance of the mechanisms, risk factors, prevention, and therapy of LAST is vital to any practitioner using local anesthetic drugs in their clinical practice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.