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Anesth Analg 2007;105:284
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000261264.82003.d7

LETTER TO THE EDITOR

Antidotes to Anesthetic Catastrophe: Lipid Emulsion and Dantrolene

Leanne Groban, MD, J. C. Gerancher, MD, Robert S. Weller, MD, and John Butterworth, MD

Department of Anesthesiology; Wake Forest University School of Medicine; Medical Center Boulevard; Winston-Salem, NC; lgroban{at}wfubmc.edu (Groban, Gerancher, Weller) Indiana University School of Medicine; Indianapolis, IN (Butterworth)

In Response:

We thank Drs. Picard, Meek, and Ward (1) for their interest in our paper (2) and their kind comments. We applaud physicians in the United Kingdom for developing consensus protocols for treatment of local anesthetic intoxication and regret that relevant specialty organizations in North America have not yet gone through the same process.

Cardiac toxicity from bupivacaine and similar compounds is every bit as much an "anesthetic disease" as malignant hyperthermia (MH). Moreover, local anesthetic cardiac toxicity may be significantly more common than MH. Therefore, it is surprising that we in the United States have protocols for the rarer disease and disappointing that we have not yet adopted a similar protocol for the more common potentially lethal problem.

REFERENCES

  1. Picard J, Meek T, Ward S. Antidotes to anesthetic catastrophe: lipid emulsion and dantrolene. Anesth Analg 2007;104:283–4.[Abstract/Free Full Text]
  2. Corcoran W, Butterworth J, Weller RS, et al. Local anesthetic-induced cardiac toxicity: a survey of contemporary practice strategies among academic anesthesiology departments. Anesth Analg 2006;103:1322–6.[Abstract/Free Full Text]




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2007 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press