Table 3 Characteristics of LAST

Onset of LAST (n = 22)

 After birth

13

 During labour or birth including CS

8

 In pregnancy

1

Types of local anaesthesia (n = 19 excluding drug errors)

 TAP block after CS

11

 Epidural CS (preceded by epidural for labour)

2

 Epidural for labour

2

 Spinal for CS

1

 Combined spinal–epidural (CSE) for labor

1

 Perineal nerve block

1

 Infiltration anaesthesia for fetal thoracentesis

1

Types of anaesthetic(n = 19, numbers overlapping)

 Bupivacaine

18

 Bupivacaine only

(8)

 Bupivacaine + other

(10)

 Ropivacaine

9

 Ropivacaine only

(2)

 Ropivacaine + other

(7)

 Lidocaine

7

 Lidocaine only

(1)

 Lidocaine + other

(6)

 Levobupivacaine

1

 Levobupivacaine + other

(1)

Potential primary causes of LAST (n = 22)

 Overdose

4

 Intravascular migration of an epidural catheter

3

 Partial intramuscular injection

1

 Wrong route drug error

3

 NR or unclear

11

Clinical manifestations (n = 22)

 Central nervous system toxicity

  Early phase

9

  Severe phase (seizure, loss of consciousness)

12

  Unclear

1

 Cardiovascular symptoms

  No

8

  Early phase

5

  Severe phase without cardiac arrest phase

3

  Cardiac arrest

3

  Unclear

3

Timing of lipid emulsion (n = 15)

 Early phase of LAST

5

 Later/severe phase of LAST without cardiac arrest

9

 Later/severe phase of LAST with cardiac arrest

1

Lipid dosage (n = 15)

 1 bolus only without any infusion

3

 1 bolus and infusion^a

9

 2 boluses without any infusion

2

 2 bolus and infusion

1