Private Practitioners Knowledge of Local Anaesthetic Systemic Toxicity (LAST)

Abstract

BACKGROUND Local anaesthetics (LAs) by definition are drugs that reversibly block the transmission of a nerve impulse, causing reversible absence of pain sensations without affecting consciousness. As a complication of local anaesthetic administration, a condition called as local anaesthetic systemic toxicity (LAST) can occur which affects central nervous system (CNS) and cardiovascular system (CVS). Local anaesthetic systemic toxicity is a very serious condition that can cause death. In LAST, blood levels of anaesthetic agent exceed the maximum dose, usually as a result of multiple injections or an accidental injection into a vein. The main objective of this survey was to assess the knowledge of LAST among private practitioners and to spread awareness about this common but often neglected complication of local anaesthetic administration. METHODS A survey was conducted with a questionnaire comprising of 15 questions for 251 private practitioners (registered in Indian Dental Association, Gurugram). The survey was mailed to the participants and the response was collected through online mode only. Using Excel program, the results were organized in graphs and tables, and presented as descriptive statistics. RESULTS Of the 251 surveys sent online, 151 were completed, with a survey completion rate of 60 %. On an average, only 39.9 % of the participating dentists had adequate knowledge of local anaesthetic systemic toxicity. Based on the survey, only 3.3 % of participating dentists knew how to use lipid treatment and 55.6 % had no idea about lipid treatment. CONCLUSIONS If LAST occurs, the key is to recognize it immediately and institute appropriate management. Based on the survey, there is a need to create awareness about local anaesthetic systemic toxicity and its management among dentists. KEY WORDS Local Anaesthesia, Last, Complication, Toxicity, Overdose