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Table 2 Characteristics of patients developing severe and major LAST events after LIA

From: Incidence of local anesthetic systemic toxicity in patients receiving bupivacaine infiltration analgesia for total joint arthroplasty under general anesthesia: a retrospective single-center study

Outcomes

Severe LAST event (n = 4)

Major LAST event (n = 41)

incidence (in the entire cohort) (per 1000)

3.16

32.36

Rescue lipid infusion

4 (100)

0

Seizure

4 (100)

11 (26.83)

Ventricular arrhythmia

0

0

Bradycardia or new-onset arrhythmia

3 (75)

32 (78.05)

Other symptoms

  

 Delayed emergence

4 (100)

17 (41.46)

 Delayed extubation

2 (50)

9 (21.95)

 Post-operative vomiting

1 (25)

6 (14.63)

Surgery

  

 Unilateral THA

2 (50)

33 (80.49)

 Bilateral THA

2 (50)

3 (7.32)

 Unilateral TKA

0 (0)

3 (7.32)

 Bilateral TKA

0 (0)

2 (4.88)

Maintained anesthetics

  

 Sevoflurane

4 (100)

33 (80.49)

 Propofol

0 (0)

8 (19.51)

Age (years old)

52.33 ± 5.51

65.14 ± 12.72

Male, n (%)

3 (75)

9 (21.95)

BMI (kg/M2)

23.71 ± 5.02

25.31 ± 3.57

Chronic diseases

  

 Arrhythmia

1 (25)

1 (2.44)

 Liver cirrhosis

0 (0)

0 (0)

 End stage renal disease

0 (0)

1 (2.44)

 CNS disease

0 (0)

0 (0)

Intraoperative blood loss (ml)

300 ± 100

240.24 ± 119.48

Duration of anesthesia (min)

111.33 ± 36.23

76.21 ± 21.45

Duration of PACU stay (min)

112.61 ± 24.42

85.17 ± 21.68

Bupivacaine dose (mg)

365.67 ± 86.75

291.09 ± 60.11

Hospitalization (days)

4.0 ± 1.0

3.73 ± 0.26

Pain score at 24 h (NRS)

1.67 ± 0.57

1.92 ± 0.65

  1. Data were presented as number (%) or mean ± standard deviation. *p < 0.05 represented a significant difference. Abbreviations: BMI, body mass index; CNS, central nervous system; LAST, local anesthetic systemic toxicity; LIA, local infiltration analgesia; NRS, numeric rating scale; PACU, post-anesthesia care unit; THA, total hip arthroplasty; TKA, total knee arthroplasty