Journal of Clinical Toxicology
Open Access

Department of Medicine, Emergency Medicine Residency Program, Good Samaritan Hospital/Catholic Health, West Islip, New York, United States

Publications

• Case Report   
  Local Anesthetic Systemic Toxicity Associated with Exparel Use
  Author(s): Samuel Hoffman*, Stephen Petrou, Andrew Leubitz and Adam Schwartz
  
  This case highlights a unique presentation of Local Anesthetic Systemic Toxicity (LAST) in a healthy young adult male following routine inguinal hernia repair surgery. Neurologic symptoms developed after the administration of both exparel and bupivacaine, albeit within their recommended safe concentrations. The symptoms occurred over an hour after administration and appeared to be more neurotoxic than cardiotoxic which is typically not what occurs with bupivacaine. Once the patient started to experience seizures after the operation was completed numerous doses of abortive IV benzodiazepines were given without successful termination of the seizures. Resolution only occurred after the patient received lipid emulsion therapy, a proposed therapy for LAST. Follow up labs and further investigation including CT and MRI of the brain did not reveal any other cause for the .. View More»
  DOI: 10.35248/2161-0495.22.12.520

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