LAST syndrome
Also written as: LAST — Local Anesthetic Systemic Toxicity
Local anesthetic systemic toxicity, a potentially fatal complication of regional anesthesia requiring immediate recognition and treatment.
Full Definition
Local Anesthetic Systemic Toxicity (LAST) syndrome occurs when local anesthetic agents reach toxic plasma concentrations, typically from inadvertent intravascular injection or absorption from large volume infiltration. Early signs include metallic taste, tinnitus, and perioral numbness, progressing to seizures and cardiovascular collapse. Treatment follows specific protocols including lipid emulsion therapy, which acts as a 'lipid sink' to sequester the lipophilic anesthetic molecules. Prevention involves careful aspiration during injection, use of test doses, and adherence to maximum safe dosing guidelines.
Usage
Usage note: Distinguish from other perioperative emergencies with similar presentations.
In Context
- "The patient developed LAST syndrome following brachial plexus block with seizure activity." — Anesthesia incident report
- "Intralipid was administered according to LAST syndrome protocol." — Critical care documentation