Local anaesthetic toxicity: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Local anaesthetic toxicity

Sample item

During a brachial plexus block, a patient develops circumoral numbness and tinnitus, then a generalised seizure followed by ventricular arrhythmia. Which specific therapy should be added to standard resuscitation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Intravenous lipid emulsion

These are features of local anaesthetic systemic toxicity, typically after inadvertent intravascular injection. Intravenous 20% lipid emulsion acts as a lipid sink and is used with airway support, seizure control and resuscitation.

Option by option

  • A. Intravenous calcium gluconate

    Calcium is used for hyperkalaemia or hypocalcaemia and does not treat local anaesthetic toxicity.

  • B. Intravenous lipid emulsion (correct)

    Correct. Lipid emulsion draws the lipophilic drug from tissues and is the specific treatment.

  • C. Intravenous naloxone

    Naloxone reverses opioids and has no effect here.

  • D. Intravenous flumazenil

    Flumazenil reverses benzodiazepines and could provoke seizures.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Intravenous lipid emulsion. These are features of local anaesthetic systemic toxicity, typically after inadvertent intravascular injection.

Why is "Intravenous calcium gluconate" not the answer?

Calcium is used for hyperkalaemia or hypocalcaemia and does not treat local anaesthetic toxicity.

Why is "Intravenous naloxone" not the answer?

Naloxone reverses opioids and has no effect here.

Why is "Intravenous flumazenil" not the answer?

Flumazenil reverses benzodiazepines and could provoke seizures.

What concept does this question test?

It tests Local anaesthetic toxicity in Anaesthesia. Intravenous 20% lipid emulsion acts as a lipid sink and is used with airway support, seizure control and resuscitation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Local anaesthetic toxicity?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.