The Effects of Lipid Emulsion on the Improvement of Glasgow Coma Scale and Reduction of Blood Glucose Level in the Setting of Acute Non-Local Drug Poisoning: A Randomized Controlled Trial

Background: Our aim was to evaluate the effect of intravenous intralipid administration as an antidote on the poisoned patientsʹ Glasgow Coma Scale (GCS), hemodynamic parameters, arterial blood gas analysis, and routine metabolic profile tests (i.e. urea, glucose, sodium, and potassium) in the setting of non-local anesthetic drug overdose. Methods: In this randomized controlled trial, a total of 30 patients with non-local anesthetic drug intoxication were enrolled and randomly assigned to case (n=15) and control (n=15) groups. In the case group, all patients received 10cc/kg intralipid 10% infusion. The patients in the control group just received supportive care. The patientsʹ demographic and clinical characteristics and the results of their laboratory tests were evaluated upon admission and 6 hours after that. Results: Mean age was 23±5 and 28±11 years in cases and controls, respectively. There were no significant statistical differences between these two groups in terms of age, gender, elapsed time between intubation and extubation, and prevalence of need for intubation and/or mechanical ventilation (P=0.70 and P= 1.00, respectively). Also, systolic blood pressure, pulse rate, mean rate- pressure product, respiratory rate, and results of acid-base gas, serum sodium, potassium, urea, and creatinine tests upon admission and six hours later were not significantly different between the two groups. However, a significant difference was found between the two groups in terms of GCS difference (P= 0.048) and blood glucose six hours after presentation (P= 0.04). Conclusions: In the setting of non-local anesthetic drug overdose, intravenous intralipid infusion can increase GCS and interestingly, decrease the blood glucose.