LAST

Medical abbreviation · Anesthesia

LAST stands for Local anesthetic systemic toxicity, an anesthesia abbreviation.

Rare but potentially fatal reaction when local anesthetic reaches high blood levels, usually after accidental intravascular injection or excessive doses. Early signs include metallic taste, ringing in the ears, numbness around the mouth and agitation, progressing to seizures, arrhythmias and cardiovascular collapse.

Example: Seizure after the paravertebral injection: LAST suspected, 20% lipid emulsion bolus given.

Usage notes

Treatment follows the American Society of Regional Anesthesia checklist: airway management, seizure control with benzodiazepines and 20 percent lipid emulsion therapy, which acts as a "lipid sink". Bupivacaine is particularly cardiotoxic. Prevention relies on ultrasound guidance, incremental injection with aspiration and respecting dose limits.

Related abbreviations

More anesthesia abbreviations

• ETT – Endotracheal tube
• FOI – Fiberoptic intubation
• GA – General anesthesia
• GETA – General endotracheal anesthesia
• ISB – Interscalene brachial plexus block
• LA – Local anesthesia (local anesthetic)
• LMA – Laryngeal mask airway
• Mac – Macintosh
• MH – Malignant hyperthermia
• NMB – Neuromuscular blockade (blocker)
• NORA – Non-operating room anesthesia
• PDPH – Post-dural puncture headache

See all 34 anesthesia abbreviations →

Edited by the AbbreviationList.com team. Spotted an error or a missing meaning? Contact us.

This entry is for general education and is not medical advice. Abbreviation use varies between institutions; always confirm in context.