Question

During cardiac arrest due to local anesthesia toxicity or unintended intravascular injection of local anesthetics, the treatment of choice is:

A) Lipid infusion
B) Vasopressin
C) Amiodarone
D) Epinephrine
E) Defibrillation alone

Answer 1

For cardiac arrest due to local anesthesia toxicity, lipid infusion is the treatment of choice because it helps in sequestering the local anesthetic from circulation, reducing its systemic toxicity.

Step-by-step explanation:

The treatment of choice for cardiac arrest due to local anesthesia toxicity or unintended intravascular injection of local anesthetics is lipid infusion. In the event of cardiac arrest, a defibrillator may be used to deliver a large shock of electrical energy, which can terminate an arrhythmia such as ventricular fibrillation, allowing the heart's natural pacemaker to resume a normal rhythm. However, in cases specifically involving local anesthetic systemic toxicity (LAST), lipid emulsion therapy is considered the first-line treatment according to the American Society of Regional Anesthesia and Pain Medicine (ASRA) guidelines. This is because lipid infusion can help in sequestering the lipophilic local anesthetic from the circulation, reducing its systemic toxicity, and recovering cardiac function.