Local anaesthetics: 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 anaesthetics: toxicity

Sample item

During bupivacaine regional anaesthesia, a patient develops tinnitus, perioral numbness, seizures and ventricular arrhythmia. What is the best immediate treatment in addition to airway support?

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

The answer and the reasoning

C. Intravenous lipid emulsion

This is local-anaesthetic systemic toxicity. Lipid emulsion acts as a drug sink and supports recovery, while bupivacaine cardiotoxicity requires careful resuscitation.

Option by option

  • A. Protamine sulfate

    Protamine reverses heparin.

  • B. Vitamin K

    Vitamin K reverses vitamin K antagonists.

  • C. Intravenous lipid emulsion (correct)

    Correct. Lipid emulsion is specific therapy for systemic local-anaesthetic toxicity.

  • D. Atropine only

    Atropine alone cannot treat seizures and cardiotoxicity.

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 C, Intravenous lipid emulsion. This is local-anaesthetic systemic toxicity.

Why is "Protamine sulfate" not the answer?

Protamine reverses heparin.

Why is "Vitamin K" not the answer?

Vitamin K reverses vitamin K antagonists.

Why is "Atropine only" not the answer?

Atropine alone cannot treat seizures and cardiotoxicity.

What concept does this question test?

It tests Local anaesthetics: toxicity in Anaesthesia. Lipid emulsion acts as a drug sink and supports recovery, while bupivacaine cardiotoxicity requires careful resuscitation.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 anaesthetics: 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.