08 Feb 09
By J Picard and W Harrop-Griffiths
A week may be a long time in politics, but in medicine changes are generally much slower. However, in at least one respect, much has changed in British anaesthesia in less than 3 years.
An editorial published in this journal in February 2006 considered the use of intravenous lipid emulsion to treat overwhelming overdoses of local anaesthetic drugs . The editorialists outlined the persuasive evidence from experiments on animals, and argued that local anaesthetic intoxication is so very rare, so catastrophic and so unpredictable that ethically acceptable, controlled human trials are, and always will be, impossible. Their conclusion was that, if a patient was in refractory cardiac arrest attributable to local anaesthetic intoxication, there would be little to lose from giving intravenous lipid, and potentially everything to gain.