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Acute emergencies from local anesthetics are generally related to high plasma levels or high dermatomal levels ("high spinal") encountered during therapeutic use of local anesthetics or to unintended intrathecal or intravascular injection of local anesthetic solution.
Management of local anesthetic emergencies: The first consideration is prevention, best accomplished by incremental injection of levobupivacaine hydrochloride monohydrate, careful and constant monitoring of cardiovascular and respiratory vital signs and the patient's state of consciousness after each local anesthetic injection and during continuous infusion. At the first sign of change, oxygen should be administered, and further measures as warranted.
