Local anaesthetic toxicity: lipid emulsion: 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.

Try it

Anaesthesia · Local anaesthetic toxicity: lipid emulsion

Sample item

A patient develops seizures and hypotension after a brachial plexus block. After airway support, what specific therapy is given?

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

The answer and the reasoning

B. 20% lipid emulsion 1.5 mL/kg bolus followed by infusion

Intravenous lipid emulsion is thought to sequester the lipophilic local anaesthetic (lipid sink). A bolus of 1.5 mL/kg of 20% emulsion over a minute is followed by an infusion of 0.25 mL/kg/min.

Option by option

  • A. Bupivacaine to treat seizures

    Bupivacaine is the cause.

  • B. 20% lipid emulsion 1.5 mL/kg bolus followed by infusion (correct)

    Correct. Lipid rescue is the specific treatment.

  • C. Digoxin

    Digoxin is irrelevant.

  • D. Propofol infusion in high dose

    High-dose propofol worsens hypotension.

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.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, 20% lipid emulsion 1.5 mL/kg bolus followed by infusion. Intravenous lipid emulsion is thought to sequester the lipophilic local anaesthetic (lipid sink).

Why is "Bupivacaine to treat seizures" not the answer?

Bupivacaine is the cause.

Why is "Digoxin" not the answer?

Digoxin is irrelevant.

Why is "Propofol infusion in high dose" not the answer?

High-dose propofol worsens hypotension.

What concept does this question test?

It tests Local anaesthetic toxicity: lipid emulsion in Anaesthesia. A bolus of 1.5 mL/kg of 20% emulsion over a minute is followed by an infusion of 0.25 mL/kg/min.

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: lipid emulsion?

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.