Do you really have a metallic taste? A survey about symptom recognition and treatment of local anesthetic toxicity in a university hospital

• Main Authors: Zaldívar , Clara Marín, Casans Francés , R, Albendea Calleja , C.D, Murillo Pina , R
• Format: Web Resource
• Language: English
• Published: Morressier 01.01.2017
• DOI: 10.26226/morressier.57108e2dd462b80290b4a0d3

BACKGROUND AND GOAL OF STUDYLocal anesthetics are drugs widely used by surgical specialists to perform invasive techniques without the supervision of an anesthesiologist. However, local anesthetic systemic toxicity is potentially fatal. Identifying intoxication symptoms and early administration of lipid emulsion are essential for its treatment. The goal of this study is to identify the level of knowledge regarding the symptoms and treatment of local anesthetic toxicity among non-anesthesiologist specialists in our hospital.MATERIAL AND METHODSAfter the approval of the project by the Management and the Unit of quality improvement of the hospital, a survey was conducted among professionals from our center (a tertiary university hospital that serves a population of 500,000 in all surgical specialties except for cardiac surgery). This survey was available on the hospitalu2019s intranet in May 2015. The survey included 6 questions about the symptoms and treatment of local anesthetic intoxication. Responses were treated anonymously, excepting for the specialization of the practitioner (anesthesiologist u2013 non-anesthesiologist). The differences between the 2 groups were analyzed by the Fisher test for dichotomous variables. Statistical analysis was performed using JMP v12.0 (SAS Institute Inc., USA).RESULTS58 professionals (14 anesthesiologists and 44 non-anesthesiologists) responded to the survey. Significant differences were found between the groups when identifying a metallic taste as an initial symptom of toxicity, the specific characteristics of bupivacaine intoxication, the cardiologic safety profile of levobupivacaine and the intravenous infusion of lipid emulsion as treatment (table 1).CONCLUSIONSThere are significant differences between anesthesiologists and non-anesthesiologists when identifying the symptoms and treatment of intoxication by local anesthetics. Therefore educational measures, focused on non-anesthesiologists, must be developed.