Ms. Aparnna Baburaj, Preceptor, Department of Anesthesia Technology, College of Health Sciences (CoHS), Gulf Medical University (GMU), United Arab Emirates, was invited as a guest speaker on October 16, 2025 for a webinar organized by the Department of Anesthesia and Operation Theatre Technology (AOTT), Yenepoya School of Allied Health Sciences (YSAHS), Mangalore, Karnataka, India, on the occasion of World Anesthesia Day 2025.
The webinar, attended by more than 150 students from Anesthesia and Operation Theatre Technology programs, focused on the topic “Local Anesthetic Systemic Toxicity (LAST): Recognition, Management, and Prevention.” Ms. Aparnna’s session provided an in-depth understanding of the mechanisms, clinical presentation, and evidence-based management of LAST—emphasizing patient safety through early recognition and preventive strategies.
The session covered the following key topics:
- Overview of Local Anesthetics: Classification into ester and amide types, with examples such as lignocaine, bupivacaine, and ropivacaine, highlighting their pharmacologic differences and clinical uses.
- Mechanism of Toxicity: Explanation of how excess plasma concentrations lead to systemic toxicity, influenced by factors such as dose, injection site vascularity, and metabolic clearance.
- Clinical Manifestations:
- Central Nervous System effects—early warning signs like circumoral numbness, tinnitus, dizziness, and seizures.
- Cardiovascular effects—progression from hypertension and tachycardia to arrhythmias, hypotension, and cardiac arrest.
- Emergency Management:
- Immediate cessation of local anesthetic administration and airway management with 100% oxygen.
- Control of seizures using benzodiazepines and avoidance of large doses of propofol.
- Lipid Emulsion Therapy (Intralipid 20%)—administration guidelines following the AAGBI recommendations: bolus 1.5 ml/kg followed by infusion 0.25 ml/kg/min.
- Mechanisms of Lipid Therapy: Discussion of the “lipid-sink” hypothesis and its role in reversing cardiac and CNS toxicity.
- Prevention Strategies: Use of the lowest effective dose, incremental injection with frequent aspiration, ultrasound guidance, proper syringe labeling, and communication during the safety “timeout.”
- Neurotoxicity and Myotoxicity: Brief review of cauda equina syndrome and transient neurological symptoms associated with certain local anesthetics.
The interactive session was enhanced with visual flowcharts outlining a stepwise approach to managing LAST, ensuring clarity and clinical relevance for learners.
The session was highly appreciated by faculty and students at Yenepoya University, and Ms. Aparnna was awarded a Certificate of Appreciation for her outstanding presentation and valuable contribution to the World Anesthesia Day 2025 event.
Dr. Praveen Kumar, Dean, College of Health Sciences, GMU stated “Our faculty’s engagement in international academic collaborations reinforces GMU’s commitment to excellence in allied health education. Ms. Aparnna’s session on such a vital clinical topic reflects the department’s dedication to promoting patient safety and fostering professional growth among future anesthesia technologists.”
