Knowledge of Local Anesthetic Systemic Toxicity among Emergency Medicine Physicians: A Cross-Sectional Study

Abstract

Background: Local anesthetics (LAs) are widely used in medical practice. The prevalence of LAs used has attracted attention with increasing reports of toxicity. To our knowledge, there is no study that surveyed emergency medicine physicians (EMPs) about local anesthetic systemic toxicity (LAST). We aimed to assess EMPs’ knowledge and awareness of LAST. Methods: This was a cross-sectional questionnaire-based study. EMPs working in the emergency department of a variety of hospitals (university, training and research, public, private) in Turkey participated in the study via e-mail. EMPs who did not use LAs and residents were excluded. The questionnaire was sent to physicians via e-mail, and responses were analyzed. Results: A total of 178 EMPs participated in the study and 20.8% and 22.5% of respondents recognized all the symptoms and treatment options of LAST respectively. About 4% had no knowledge on intravenous lipid emulsion (ILE) treatment, 41.6% used ILE treatment, and 42.1% were correct in the treatment dose of ILE. A significant correlation was found between the type of hospital and related training and the correct response of the ILE dose. Participants working at a university hospital had significantly higher correct answers (58.3%) on the treatment dose of ILE, but the correlation was weak (r: 0.165). Conclusion: Although LAST might have high mortality and morbidity in emergency patients, the level of EMPs’ knowledge and awareness of LAST is poor. The current training about LAs should be increased and standardized. EMPs should be encouraged to use ILE if indicated.