Local and regional anaesthesia: seizure from 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 and regional anaesthesia: seizure from local anaesthetic toxicity

Sample item

Ten minutes after a supraclavicular block with bupivacaine, a patient develops a generalised tonic-clonic seizure. Which drug is the preferred first choice to stop the seizure?

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

The answer and the reasoning

B. Midazolam

Seizures from local anaesthetic toxicity are treated with a benzodiazepine, and airway and oxygenation are secured at the same time. Phenytoin acts too slowly, and further local anaesthetic adds to the toxic load.

Option by option

  • A. Lignocaine

    Lignocaine is itself a local anaesthetic and would add to the toxicity.

  • B. Midazolam (correct)

    Correct. A benzodiazepine stops the seizure quickly.

  • C. Magnesium sulphate

    Magnesium is used for eclamptic seizures and is not the standard here.

  • D. Phenytoin

    Phenytoin has a slow onset and is not suitable for an acute toxic seizure.

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, Midazolam. Seizures from local anaesthetic toxicity are treated with a benzodiazepine, and airway and oxygenation are secured at the same time.

Why is "Lignocaine" not the answer?

Lignocaine is itself a local anaesthetic and would add to the toxicity.

Why is "Magnesium sulphate" not the answer?

Magnesium is used for eclamptic seizures and is not the standard here.

Why is "Phenytoin" not the answer?

Phenytoin has a slow onset and is not suitable for an acute toxic seizure.

What concept does this question test?

It tests Local and regional anaesthesia: seizure from local anaesthetic toxicity in Anaesthesia. Phenytoin acts too slowly, and further local anaesthetic adds to the toxic load.

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 and regional anaesthesia: seizure from 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.