Objective: The primary aim of this study is to evaluate the knowledge, perception, and attitudes of residents working in intensive care units from different disciplines about local anesthetic systemic toxicity (LAST).
Methods: Residents from anesthesiology and reanimation, internal medicine, cardiovascular surgery, thoracic surgery, and cardiology were enrolled in the study after they obtained written informed consent. The participants answered 41 questions about local anesthetics and LAST.
Results: A total of 148 residents [median age 28 (24-44) years, 56.1% male] were enrolled in the study. Of them, 34.5% stated that they received education on local anesthetics, and 22.3% declared that their education on this subject was sufficient. The most used methods for preventing LAST were the use of appropriate doses (74.3%), pre-injection aspiration (65.5%), and monitoring (63.5%). Of the participants, 59.5% indicated that they did not know whether there was 20% lipid-emulsion in their hospital and 72.3% in their unit. The participants had a low knowledge rate of early and late symptoms of LAST. They also gave rarely correct answers about the loading, maintaining, and maximum doses of 20% lipid emulsion. The basic principles of cardiopulmonary resuscitation in LAST were generally well known by participants, but the optimal length of the follow-up duration after convulsion and cardiovascular instability was not.
Conclusion: Prevention, recognition, management of the LAST, and the following of the patients with LAST are essential for patient safety in the intensive care unit. Residents working in intensive care units should be educated about LAST regardless of their branch.