Local Anesthetic Toxicity in the Geriatric Population

This article provides a concise overview of local anesthetic systemic toxicity, its history, mechanisms, risk factors, prevention, clinical presentation, and treatment, with a special emphasis on issues specific to the geriatric population. The authors used MEDLINE, Scopus, and Google Scholar to search for original research articles (human and animal studies), registries data, case reports, review articles, and pertinent online publications using the combinations of the following search terms: local anesthetics, local anesthetic systemic toxicity, intralipid, lipid emulsion, Exparel, ultrasound-guidance, regional anesthesia, lidocaine, bupivacaine, ropivacaine, cocaine, procaine, tetracaine, levobupivacaine, liposomal bupivacaine, lignocaine. Local anesthetic systemic toxicity continues to occur despite the use of putatively less cardiotoxic formulations of local anesthetics and more common use of ultrasound guidance. The elderly appear to be at a disproportionately increased risk for toxicity owing to the presence of relevant comorbidities and decreased muscle mass. Examination of recent case reports involving patients over the age of 65  years demonstrates that inadvertent overdosing is responsible for some cases of local anesthetic systemic toxicity. Elderly patients are at increased risk of local anesthetic systemic toxicity. When considering use of local anesthetics in older patients, special attention should be paid to the pre sence of systemic disease and muscle w...
Source: Drugs and Aging - Category: Geriatrics Source Type: research

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Publication date: Available online 6 December 2019Source: Preventive MedicineAuthor(s): Elisabeth R. Silver, Chin HurAbstractThe majority of research on gender and the opioid epidemic focuses on women as patients, caregivers, or expectant mothers. However, little research approaches men as gendered subjects, despite their dramatically increased risk of opioid overdose. Accordingly, we examined gender differences in prescription opioid use and misuse with specific attention to implications for men using data from the 2017 National Survey on Drug Use and Health. We used design-adjusted, weighted Wald tests and multivariate l...
Source: Preventive Medicine - Category: International Medicine & Public Health Source Type: research
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Source: Cliffside Malibu - Category: Addiction Authors: Tags: Addiction Recovery Detox Resources for Alcohol and Drugs/Opiates drug detox medical detox medicated-assisted detox opioid opioids prescription drug detox withdrawal withdrawal symptoms Source Type: blogs
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Source: CBC | Health - Category: Consumer Health News Tags: News/Canada/British Columbia Source Type: news
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Source: Psychiatr News - Category: Psychiatry Tags: ajp in advance Arthur Robin Williams buprenorphine emergency department visits inpatient hospitalizations Medicaid opioid use disorder retention in treatment Source Type: research
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Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
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Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
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Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
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Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
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Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
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