脂肪乳用于长效局麻药中毒的救治

Employment of lipid emulsion in the resuscitation for long-acting local anesthetic toxicity

长效局麻药（local anesthetic，LA）中毒所致顽固性心跳骤停，目前临床尚无有效便捷的治疗方法。动物研究发现静脉注射脂肪乳（lipid emulsion，LE）可治疗布比卡因所致心跳骤停。因尚缺乏有力的临床研究证据支持，文献建议LE作为LA心脏毒性标准心肺复苏的备用措施。但多例个案报道提示，一旦出现LA毒性症状，应尽早使用LE救治，以避免LA毒性综合征的发展。未来的研究方向应致力于探索LE救治有效性的确切机制，寻求临床适用的最佳使用方法，确立治疗标准。

There are no effective and convenient therapeutic management on refractory cardiac arrest induced by long-acting local anesthetic toxicity. Although there are no any randomly controlled trials showing the effectiveness of lipid emulsion for anesthetic toxicity resuscitation in human beings mostly because of ethic issues, lipid emulsion has been proved to be effective in anihaal models undergoing local anesthetic toxicity. This novel approach to treating potentially fatal cardiac toxicity is still at an early stage but holds promise for clinical application. Literatures suggest that lipid emulsion resuscitation should be as a reserve step because of lacking clinical investigative evidence. However, more and more case reports indicate that lipid emulsion should be used earlier in order to avoid local anesthetic toxicity deteriorated. Further work is required to explore mechanism of lipid emulsion on resuscitation of local anesthetic toxicity and optimize the treatment regimens with respect to efficacy and safety of lipid rescue.