Local anaesthetic agent toxicity

Although the toxicity of local anaesthetic agents is unequivocal and often impressive, it should be kept in mind that these drugs have a long track record of safety when used correctly, and may even confer benefits on patients beyond their immediately apparent pharmacological actions. All local anaesthetic agents should, however, be assumed to have extreme toxic potential. In order to prevent complications arising from the use of these agents, the following guidelines have been proposed: • Carefully consider indications and contra-indications. • Do not administer more local anaesthetic agent than is necessary: - Lowest effective concentration; - Lowest effective volume; - Limit duration of infusion. • Fractionate doses, where possible. • Maintain contact with your patient during administration.