Article: Local Anesthetics: Helpful Science, but Don't Forget the Basic Clinical Safety Steps

We have come a long way in our understanding and treatment of the toxicity of local anesthetics since the tragic reports in 1979 that reminded us that the then newer, more potent, aminoamide local anesthetics may also be potentially more toxic.1 In the past 25 years, we have made major changes in our approach to the so-called safety steps associated with regional techniques. Moore and Batra2 reminded us early on that the traditional "test dose" was not adequate, and we needed to pay more attention to the details of that solution and our monitoring of its effects.

Extensive laboratory data in many animal models gave us a more profound understanding of the mechanism of toxicity of the potent ...

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