International Pain and Spine Intervention Society Emergency Protocols: Local Anesthetic Systemic Toxicity (LAST).

This protocol outlines the pathophysiology, recognition, and treatment of Local Anesthetic Systemic Toxicity (LAST), a rare but life-threatening complication caused by excessive systemic absorption or intravascular injection of local anesthetics. Clinical manifestations may include seizures, arrhythmias, and cardiovascular collapse. The protocol emphasizes rapid identification, lipid emulsion therapy, airway management, seizure control, and modified Advanced Cardiovascular Life Support measures.