Oral and maxillofacial surgery and facial fractures: local anaesthetic systemic toxicity: practice question

A Dentistry 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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Dentistry · Oral and maxillofacial surgery and facial fractures: local anaesthetic systemic toxicity

Sample item

After an inadvertent intravascular injection of bupivacaine, a patient has perioral tingling, seizures and then cardiovascular collapse that does not respond to standard resuscitation. Which therapy is specifically recommended?

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

The answer and the reasoning

D. Intravenous lipid emulsion

Local anaesthetic systemic toxicity causes neurological symptoms followed by cardiotoxicity, especially with bupivacaine. In addition to airway support, seizure control and CPR, intravenous lipid emulsion is given as a rescue therapy.

Option by option

  • A. Intravenous atropine alone

    Atropine alone does not correct the cardiac toxicity of local anaesthetics.

  • B. Intravenous naloxone

    Naloxone reverses opioids.

  • C. Intravenous flumazenil

    Flumazenil reverses benzodiazepines.

  • D. Intravenous lipid emulsion (correct)

    Correct. Lipid emulsion acts as a sink for the lipophilic local anaesthetic.

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 Dentistry question

What is the answer to this Dentistry question?

The best answer is D, Intravenous lipid emulsion. Local anaesthetic systemic toxicity causes neurological symptoms followed by cardiotoxicity, especially with bupivacaine.

Why is "Intravenous atropine alone" not the answer?

Atropine alone does not correct the cardiac toxicity of local anaesthetics.

Why is "Intravenous naloxone" not the answer?

Naloxone reverses opioids.

Why is "Intravenous flumazenil" not the answer?

Flumazenil reverses benzodiazepines.

What concept does this question test?

It tests Oral and maxillofacial surgery and facial fractures: local anaesthetic systemic toxicity in Dentistry. In addition to airway support, seizure control and CPR, intravenous lipid emulsion is given as a rescue therapy.

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 Oral and maxillofacial surgery and facial fractures: local anaesthetic systemic toxicity?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry 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.