In LAST management, which agent is used to treat seizures?

In LAST management, which agent is used to treat seizures?

• A. Propofol
• B. Phenytoin
• C. Levetiracetam
• D. Benzodiazepines

Answer: (D)

In LAST management, the main goal during seizures is to rapidly suppress CNS excitation caused by local anesthetic toxicity. Benzodiazepines fit this best because they enhance the GABA-A receptor’s inhibitory effect, increasing chloride influx into neurons and quickly stopping convulsions. This direct dampening of neuronal activity helps prevent ongoing seizures from worsening cerebral hypoxia and acidosis, and they typically have a more favorable immediate safety profile in the LAST setting than other anticonvulsants. If seizures persist after benzodiazepines, additional options like propofol can be used with caution due to potential cardiovascular depression; phenytoin is less favored because it can cause hypotension and has slower onset, while levetiracetam can be a reasonable alternative if needed.

In LAST management, the main goal during seizures is to rapidly suppress CNS excitation caused by local anesthetic toxicity. Benzodiazepines fit this best because they enhance the GABA-A receptor’s inhibitory effect, increasing chloride influx into neurons and quickly stopping convulsions. This direct dampening of neuronal activity helps prevent ongoing seizures from worsening cerebral hypoxia and acidosis, and they typically have a more favorable immediate safety profile in the LAST setting than other anticonvulsants. If seizures persist after benzodiazepines, additional options like propofol can be used with caution due to potential cardiovascular depression; phenytoin is less favored because it can cause hypotension and has slower onset, while levetiracetam can be a reasonable alternative if needed.