ReviewDrugs & aging2020
Local Anesthetic Toxicity in the Geriatric Population.
Review in Drugs & aging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 56 citations in OpenAlex.
- Periarticular injection and hamstring block versus placebo for pain control in anterior cruciate ligament reconstruction: A randomized controlled trial.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Trial
- Case Report: Local anesthetic systemic toxicity during regional anesthesia in a patient with rheumatoid arthritis.Frontiers in medicine · 2026Article
- Association of Scalp Nerve Block with Perioperative Outcomes and Postoperative Complications During Subthalamic Nucleus Deep Brain Stimulation: A Single-Center Retrospective Cohort Study.Journal of pain research · 2026Article
- Lumbar Erector Spinae Plane Block as a Main Anesthetic Technique versus Spinal Anesthesia Combined with PENG Block for Urgent Intertrochanteric Fracture Surgery in Elderly Patients: Preliminary Results from a Multicenter Pilot Study.Local and regional anesthesia · 2026Article
- Potentially unsafe doses of local anesthetics in axillary brachial plexus block: A single-center retrospective cohort study.PloS one · 2026Article
- Addressing human factors in the recognition and management of local anaesthetic systemic toxicity.Journal of perioperative practice · 2025Review
- Research progress of liposomal bupivacaine and its value in perioperative pain management.JPRAS open · 2025Review
- Article
- Urolithin A attenuates bupivacaine-induced neurotoxicity in SH-SY5Y cells by regulating the SIRT1-activated PI3K/AKT pathway.Histology and histopathology · 2024Article
- Postoperative Multimodal Analgesia Strategy for Enhanced Recovery After Surgery in Elderly Colorectal Cancer Patients.Pain and therapy · 2024Review
- Enhancing the comfort of hospitalized elderly patients: pain management strategies for painful nursing procedures.Frontiers in medicine · 2024Article
- Ropivacaine-loaded hydrogels for prolonged relief of chemotherapy-induced peripheral neuropathic pain and potentiated chemotherapy.Journal of nanobiotechnology · 2023Article
- Drug-microbiota interactions: an emerging priority for precision medicine.Signal transduction and targeted therapy · 2023Review
- Systemic Ropivacaine Concentrations Following Local Infiltration Analgesia and Femoral Nerve Block in Older Patients Undergoing Total Knee Arthroplasty.Local and regional anesthesia · 2023Article
- Nationwide multidisciplinary consensus on the clinical management of Merkel cell carcinoma: a Delphi panel.Journal for immunotherapy of cancer · 2022Article
- Comparison of general anesthesia and continuous intravenous sedation for electrochemotherapy of head and neck skin lesions.Frontiers in oncology · 2022Article
- Development and Preliminary Validation of LoAD Calc, a Mobile App for Calculating the Maximum Safe Single Dose of Local Anesthetics.Healthcare (Basel, Switzerland) · 2021Article
- Outcome of early stage Merkel carcinoma treated by exclusive radiation: a study of 53 patients.Radiation oncology (London, England) · 2021Article
- Mechanisms and Efficacy of Intravenous Lipid Emulsion Treatment for Systemic Toxicity From Local Anesthetics.Frontiers in medicine · 2021Review
- Regional anesthesia for geriatric population.Saudi journal of anaesthesiaReview
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This article provides a concise overview of local anesthetic systemic toxicity, its history, mechanisms, risk factors, prevention, clinical presentation, and treatment, with a special emphasis on issues specific to the geriatric population. The authors used MEDLINE, Scopus, and Google Scholar to search for original research articles (human and animal studies), registries data, case reports, review articles, and pertinent online publications using the combinations of the following search terms: local anesthetics, local anesthetic systemic toxicity, intralipid, lipid emulsion, Exparel, ultrasound-guidance, regional anesthesia, lidocaine, bupivacaine, ropivacaine, cocaine, procaine, tetracaine, levobupivacaine, liposomal bupivacaine, lignocaine. Local anesthetic systemic toxicity continues to occur despite the use of putatively less cardiotoxic formulations of local anesthetics and more common use of ultrasound guidance. The elderly appear to be at a disproportionately increased risk for toxicity owing to the presence of relevant comorbidities and decreased muscle mass. Examination of recent case reports involving patients over the age of 65 years demonstrates that inadvertent overdosing is responsible for some cases of local anesthetic systemic toxicity. Elderly patients are at increased risk of local anesthetic systemic toxicity. When considering use of local anesthetics in older patients, special attention should be paid to the presence of systemic disease and muscle wasting. The safety of regional anesthesia and multi-modal analgesia among these at-risk patients will be improved by educating physicians and staff to recognize and manage local anesthetic systemic toxicity.
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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.