Knowledge of Dentistry Students on Local Anesthetic Systemic Toxicity and Intravenous Lipid Rescue Therapy: A Cross-Sectional Questionnaire-Based Study

Abstract views: 85 / PDF downloads: 52




Local anesthetics, dentistry, toxicity, local anesthetic systemic toxicity, lipid emulsion


Objective: This study aimed to evaluate the level of knowledge of dentistry students on local anesthetic systemic toxicity (LAST), which will provide important information that will help in scheduling the educational content of the future syllabus before graduation, in order to prepare the students for possible challenges in the future.
Methods: This study included 234 dentistry students who were in the 3rd, 4th, and 5th years of education, at 2018–2019 educational year of Gaziantep University, Faculty of Dentistry. It was conducted in a cross-sectional questionnaire-based manner. The revised questionnaire form included questions regarding the frequency of encountered LAST cases, signs of LAST they had observed, and treatments for LAST that they had used, particularly lipid treatment.
Results: The questionnaire was sent to 234 dentistry students who were in the 3rd, 4th, and 5th degree in the Gaziantep University Faculty of Dentistry and 215 of them responded to the study (91,88%). The majority of the participants (93%, n = 200) declared that they had received training about LAs. Among the participants, 38,60% (n = 83) of them preferred only one LA agent, whereas the remaining participants preferred multiple agents. In addition, most of the participants 79,5% (n = 171) declared that they had not observed LAST, while only 15 of the students stated that they have encountered LAST (7%) and had used an alternative therapy rather than the intravenous lipid rescue therapy. None of the students personally administered the lipid rescue therapy.
Conclusion: The results of this current study demonstrate the evident need for additional educational effort to create awareness regarding LA use and the effective management of LAST among dentistry students.


Metrics Loading ...


Sagir A, Goyal R. An assessment of the awareness of local anesthetic systemic toxicity among multi-specialty postgraduate residents. J Anesth 2015; 29: 299-302.

Walsh AM, Moran B, Walsh SA. Knowledge of local anesthetic use among dermatologists. Dermatol Surg 2012; 38: 882-7.

Jensen-Gadegaard P, Skjønnemand M, Damgaard-Jensen J, Gottschau B. Limited knowledge of lipid rescue therapy in local anaesthetic systemic toxicity. Dan Med Bull 2011; 58: A4226.

Oksuz G, Urfalioglu A, Sekmen T, Akkececi N, Alpay N, Bilal B. Dentists knowledge of lipid treatment of local anaesthetic systemic toxicity. Niger J Clin Pract 2018; 21: 327-31.

Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesthesiology 1979; 51: 285-7.

Di Gregorio G, Neal JM, Rosenquist RW, Weinberg GL. Clinical presentation of local anesthetic systemic toxicity: review of published cases, 1979 to 2009. Reg Anesth Pain Med 2010; 35: 181-7.

Association of Anaesthetists of Great Britain and Ireland. Intralipid in the management of LA toxicity: guidance from the Association of Anaesthetists of Great Britain and Ireland (AAGBI), 2007. http:// docs/latoxicity07.pdf (accessed 26 Aug 2009).

Neal JM, Bernards CM, Butterworth JF 4th, Di Gregorio G, Drasner K, Hejtmanek MR, et al. ASRA practice advisory on local anesthetic systemic toxicity. Reg Anesth Pain Med 2010; 35: 152-61.

Rhee SH, Park SH, Ryoo SH, Karm MH. Lipid emulsion therapy of local anesthetic systemic toxicity due to dental anesthesia. J Dent Anesth Pain Med 2019; 19: 181-9.

Taghavi Zenouz A, Ebrahimi H, Mahdipour M, Pourshahidi S, Amini P, Vatankhah M. The Incidence of Intravascular Needle Entrance during Inferior Alveolar Nerve Block Injection. J Dent Res Dent Clin Dent Prospects 2008; 2: 38-41.

El-Boghdadly K, Pawa A, Chin KJ. Local anesthetic systemic toxicity: current perspectives. Local Reg Anesth 2018; 11: 35-44.

Pinheiro AC, Marques JF, Vieira MS, Branco De Almeida LS. Dentists’ knowledge regarding signs and symptoms of the systemic toxicity of local anesthetic solutions. Rev Gaúch Odontol 2015; 63: 41-6.

Donald MJ, Derbyshire S. Lignocaine toxicity; a complication of local anaesthesia administered in the community. Emerg Med J 2004; 21: 249-50.

Dorf E, Kuntz AF, Kelsey J, Holstege CP. Lidocaine-induced altered mental status and seizure after hematoma block. J Emerg Med 2006; 31: 251-3.

Marra DE, Yip D, Fincher EF, Moy RL. Systemic toxicity from topically applied lidocaine in conjunction with fractional photothermolysis. Arch Dermatol 2006; 142: 1024-6.

Ferguson W, Coogle C, Leppert J, Odom-Maryon T. Local Anesthetic Systemic Toxicity (LAST): Designing an Educational Effort for Nurses That Will Last. J Perianesth Nurs 2019; 34: 180-7.

Urfalıoğlu A, Urfalıoğlu S, Öksüz G. The Knowledge of Eye Physicians on Local Anesthetic Toxicity and Intravenous Lipid Treatment: Questionnaire Study. Turk J Ophthalmol 2017; 47: 320-5.




How to Cite

Kaya Uğur, B. (2020). Knowledge of Dentistry Students on Local Anesthetic Systemic Toxicity and Intravenous Lipid Rescue Therapy: A Cross-Sectional Questionnaire-Based Study. European Journal of Therapeutics, 26(4), 312–316.



Original Articles