Regional Anesthesia Facilitates the Early Recognition of Local Anesthetic Toxicity

Rising concerns regarding the potential long-term neurocognitive effects of general anesthetic agents have renewed an interest in using regional anesthesia instead of general anesthesia in infants. Although generally safe and effective, the primary risk associated with regional anesthesia relates to the use of large doses of local anesthetic agents and the potential for local anesthetic systemic toxicity (LAST). We present three infants who suffered LAST after receiving regional anesthesia instead of general anesthesia. The early signs and symptoms were quickly identified in the awake state thereby allowing for cessation of continuous drug administration and a rapid response to treat LAST before progression to severe sequelae.