Evidence map›Paper›PMID 38355477›Full record

ArticleBMC pregnancy and childbirth2024

Intravenous lipid emulsion for local anaesthetic systemic toxicity in pregnant women: a scoping review.

Makoto Tsuji, Masafumi Nii, Marie Furuta, Shinji Baba, Takahide Maenaka, Shigetaka Matsunaga, Hiroaki Tanaka, Atsushi Sakurai, Japan Resuscitation Council (JRC) of the Guideline Editorial Committee

Open access · goldAbstract readScoping Review
In one paragraph

Article in BMC pregnancy and childbirth, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
4.6field-weighted citation impact, top 5% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 11 institutions in 2 countries.

Makoto TsujiDepartment of Obstetrics and Gynecology, Saiseikai Mastusaka General Hospital, Mastusaka, Mie, Japan.
Masafumi NiiDepartment of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie, Japan. m-nii1984@med.mie-u.ac.jp.
Marie FurutaDepartment of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto, Japan.
Shinji BabaDepartment of Obstetrics and Gynecology, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan.
Takahide MaenakaRegional Medical Care Planning Division, Health Policy Bureau, Ministry of Health, Labour and Welfare, Tokyo, Japan.
Shigetaka MatsunagaDepartment of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Hiroaki TanakaDepartment of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie, Japan.
Atsushi SakuraiDepartment of Acute Medicine, Division of Emergency and Critical Care Medicine, Nihon University School of Medicine, Itabashi, Tokyo, Japan.
Japan Resuscitation Council (JRC) of the Guideline Editorial Committee
Mie University · JPSocial Insurance Saitama Chuo Hospital · JPTokyo Metropolitan Tama Medical Center · JPJapanese Red Cross Medical Center · JPJuntendo University · JPKyoto Prefectural University · JPKyoto University · JPMinistry of Health Labour and Welfare · JPNihon University · JPSakakibara Hospital · JPShowa University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLocal anaesthetic systemic toxicity (LAST) is a rare but life-threatening complication that can occur after local anaesthetic administration. Various clinical guidelines recommend an intravenous lipid emulsion as a treatment for local anaesthetic-induced cardiac arrest. However, its therapeutic application in pregnant patients has not yet been established. This scoping review aims to systematically identify and map the evidence on the efficacy and safety of intravenous lipid emulsion for treating LAST during pregnancy.

methodWe searched electronic databases (Medline, Embase and Cochrane Central Register Controlled Trials) and a clinical registry (lipidrescue.org) from inception to Sep 30, 2022. No restriction was placed on the year of publication or the language. We included any study design containing primary data on obstetric patients with signs and symptoms of LAST.

resultsAfter eliminating duplicates, we screened 8,370 titles and abstracts, retrieving 41 full-text articles. We identified 22 women who developed LAST during pregnancy and childbirth, all presented as case reports or series. The most frequent causes of LAST were drug overdose and intravascular migration of the epidural catheter followed by wrong-route drug errors (i.e. intravenous anaesthetic administration). Of the 15 women who received lipid emulsions, all survived and none sustained lasting neurological or cardiovascular damage related to LAST. No adverse events or side effects following intravenous lipid emulsion administration were reported in mothers or neonates. Five of the seven women who did not receive lipid emulsions survived; however, the other two died.

conclusionStudies on the efficacy and safety of lipids in pregnancy are scarce. Further studies with appropriate comparison groups are needed to provide more robust evidence. It will also be necessary to accumulate data-including adverse events-to enable clinicians to conduct risk-benefit analyses of lipids and to facilitate evidence-based decision-making for clinical practice.

Indexed as

Anesthetics, LocalFat Emulsions, IntravenousFemaleHumansInfant, NewbornLipidsParturitionPregnancyPregnant PeopleAnesthetics, LocalFat Emulsions, IntravenousLipidsAnaesthesiaAnalgesia – ObstetricEmergency medicineLipid emulsionResuscitationShock

Identifiers

PMID38355477
PMCPMC10865663
OpenAlexW4391814549

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.