Toxicidad sistémica por anestésicos locales: consideraciones generales, prevención y manejo

Ricardo Sergio Fuentes Henríquez, Ian Javier Molina Paolini, José Ignacio Contreras Castilla, Claudio Enrique Nazar Jara

Resumen


La administración de anestésicos locales se lleva a cabo en distintos escenarios clínicos y por diferentes profesionales de la salud, principalmente, médicos y odontólogos. Su uso está asociado a complicaciones de baja frecuencia como edema, urticaria y dermatitis, pero la intoxicación por anestésicos locales puede ser fatal. La presentación clínica de esta complicación es muy variable y abarca un gran espectro de síntomas relacionados principalmente con la toxicidad neurológica y cardiovascular, incluyendo presentaciones atípicas. La prevención de la toxicidad sistémica se basa en considerar los factores de riesgo para su presentación, elegir cuidadosamente el anestésico local y la dosis a administrar, aspirar antes de inyectar, fraccionar la dosis y el uso de marcadores de inyección intravascular. El manejo de la intoxicación por anestésicos locales incluye un manejo de la vía aérea, control de las convulsiones, mantención de la circulación sistémica y el uso de terapia intravenosa con emulsión lipídica

Palabras clave


Anestésico local; administración y dosis; efectos adversos; toxicidad; emulsiones grasas intravenosas

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Referencias


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DOI: http://dx.doi.org/10.11565/arsmed.v42i3.995



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