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50th Annual Regional Anesthesiology and Acute Pain Medicine Meeting
May 1 - 3, 2025 | Orlando, Florida
6713
THE INCIDENCE OF A SINGLE-SHOT LOCAL ANESTHETIC OVERDOSE IS MORE PREVALENT IN FEMALES THAN IN MALES, IRRESPECTIVE OF BMI
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Scientific Abstracts > Regional Anesthesia
The incidence of a single-shot local anesthetic overdose is more prevalent in females than in males, irrespective of BMI
Kamonchanok Tengwongderm1, Jean Louis Horn1 , Ban Tsui1, 2
Peripheral Nerve Blocks in Modern Anesthesia
•Peripheral nerve blocks are crucial in modern anesthesia for pain relief.
•Advancements in local anesthetic techniques, like high-volume fascial plane blocks and continuous catheters, increase risk of local anesthetic systemic toxicity (LAST).
•Risk factors include LA dose, vascularity, age, sex, muscle mass, and organ failure.
•Traditional dosing relies on total body weight (TBW), but recent literature suggests lean body weight (LBW) for accurate dosing.
•Study compares LBW-based and TBW-based ropivacaine doses, focusing on gender, age, and BMI.
Retrospective Analysis of Single-Shot Peripheral Nerve Blocks
•500 patients analyzed (December 2023–July 2024).
•Data included demographics, block types, LA used, LAST incidents.
•LBW calculated using Boer equation.
•Statistical analyses included t-tests and
•Mann–Whitney U tests.
500 Patients Received Ropivacaine as Local Anesthetic
•LBW-based doses were higher than TBW-based doses.
•20.2% of patients exceeded LBW-based maximum dose.
•No overt LAST cases reported.
Females and Elderly Patients' LBW-Based Dose Excess
•Females received higher LBW-based doses than males, with 39.53% exceeding the maximum dose.
•Elderly patients (≥65 years) were more likely to exceed dosage thresholds, with 56.5% exceeding the reduced threshold of 2.4 mg/kg.
•Non-obese patients were more likely to exceed the limit (69.31%) than obese patients (30.69%), with higher LBW-based doses.
•A low negative correlation (r =-0.11) between BMI and LBW-based doses.
Balancing Weight-Based Formulas for Overdose Risks
•Essential to balance formulas with considerations.
•Procedural efficacy crucial, but may increase overdose risk in vulnerable populations.
•Emphasizes need for careful dosing strategies.