A response to a previously published article or letter can be submitted to the Online Correspondence section at http://www.anaesthesiacorrespondence.com. A selection of this correspondence is published several times a year in Anaesthesia. All correspondence intended for publication in Anaesthesia should be addressed to Dr David Bogod, Editor-in-Chief, and submitted as an e-mail attachment to firstname.lastname@example.org. For multi-author letters, a covering letter signed by all authors must be submitted either by post, fax (44 (0) 115 962 7670) or by e-mail as a scanned document before correspondence can be published. Alternatively, letters may be submitted typewritten on one side of paper, double spaced with wide margins to Anaesthesia, 1st Floor, Maternity Unit, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK. All paper submissions must include a signed covering letter, a disc or CD-ROM with a Word for Windows or .rtf version of the letter and an email address for the corresponding author. Copy should be prepared in the usual style of the Correspondence section. Authors must follow the advice about references and other matters contained in the Author Guidelines at http://www.blackwellpublishing.com/journals/ana/submiss.htm. Correspondence presented in any other style or format will be returned to the author for revision.
Another use for lipid rescue?
Article first published online: 10 JAN 2007
Volume 62, Issue 2, page 204, February 2007
How to Cite
Wheeler, D.W. (2007), Another use for lipid rescue?. Anaesthesia, 62: 204. doi: 10.1111/j.1365-2044.2007.04976.x
- Issue published online: 10 JAN 2007
- Article first published online: 10 JAN 2007
I note with interest the recent correspondence concerning the use of lipid rescue for cardiac arrest caused by local anaesthetic toxicity [1, 2], and the theories about the possible mechanisms of action. I would like to ask those who have had successfully used lipid rescue in resuscitation whether they have ever had the opportunity to evaluate whether the regional block was still working after the lipid infusion had been administered? If the block had disappeared, this might imply that the lipid acts as a ‘lipid sink’. If, however, the block remains, this would give weight to the argument that the lipids influence acylcarnitine exchange in cardiac mitochondria .
A rare complication of peripheral nerve block is that it may persist for days or even weeks, causing concern for patients and anaesthetists alike. This is difficult to explain on the basis of the pharmacokinetic and pharmacodynamic properties of local anaesthetics ; however, it may be equally difficult to attribute the symptoms to direct nerve injury. The use of lipid outside its licence would need to be discussed in detail with the patient, but perhaps a lipid infusion might also be helpful in these unusual circumstances?
- 5Drugs in Anaesthesia and Intensive Care, 3rd edn. Oxford: Oxford University Press, 2003., .