Guideline Post

Checklist for Treatment of Local Anesthetic Systemic Toxicity (LAST)

Nov 1, 2020

ASRA Pain Medicine

Local anesthetic systemic toxicity (LAST) is a rare but life-threatening complication of regional anesthesia administration. Practitioners should be prepared to respond quickly to a local anesthetic overdose. ASRA convened a symposium on LAST in 2001 which led to a series of articles addressing potential treatments. In 2008, ASRA created a Practice Advisory on Neurological Complications of Regional Anesthesia and Pain Medicine, and in 2010, the ASRA Local Anesthetic Systemic Toxicity checklist was developed to guide management. The checklist has been revised over the years based on additional evidence and advances in medical knowledge. Authors Joseph M. Neal, Erin J. Neal, and Guy L. Weinberg revised the checklist again in 2020. 

Read the 2020 report. 

LAST Checklist

Copyright © 2020 by the American Society of Regional Anesthesia and Pain Medicine, which hereby grants practitioners the right to reproduce the checklist graphic as part of a clinical system for managing LAST. Formats suitable for reproduction and lamination can be obtained at free of charge.

Scholarly publication of these recommendations should be cited as: Neal et al Publication or reproduction of the checklist for commercial use requires written permission from ASRA. Graphic: Erin J. Neal. ACLS, Advanced Cardiac Life Support; LAST, Local Anesthetic Systemic Toxicity.

Publication of these recommendations requires written permission from ASRA

Download the full printable checklist (PDF)

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