Episode 20: Local Anesthetic Systemic Toxicity Update - LAST

The ASRA RAPP podcast episode centers on the updated practice advisory for managing local anesthetic systemic toxicity (LAST). It highlights key changes in the management algorithm, emphasizing the importance of recognizing LAST-induced dysrhythmias and cardiac arrest, which require modified ACLS protocols. The discussion underscores simplified lipid emulsion dosing strategies, advocating for a standardized bolus and infusion approach based on patient weight. Experts stress that all local anesthetics, including ropivacaine and lidocaine, pose a risk of toxicity, urging vigilance regardless of the specific drug used. The podcast introduces the concept of a LAST rescue kit, recommending readily available components like lipid emulsion and a checklist. It also addresses the need to educate non-anesthesiologists about LAST and its management.