This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Anaesthesia
[{'content': 'Bupivacaine toxicity treated with – a) Esmololb) Epinephrinec) Lignociained) 5 percent dextrosee) Benzodiazepines \nSelect and explain. \nA. ab, B. ad, C. bc, D. be', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Treatment of local anesthetic toxicity\n\nFirst step is to ensure adequate oxygenation, by face mask or intubation.\nLA infusion should be stopped immediately.\nAnticonvulsants like benzodiazepines (midazolanz) and barbiturates (thiopentone) are the drugs of choice for seizure control. Propofol can also be used.\nFor hypotension, IV fluid and vasopressor agents may be used, e.g. epinephrine, dopamine, dobutamine or vasopressine. Epinephrine remains the drug of choice for circulatory collapse.\nFor arrhythmias, amiodarone is the DOC. Bretylium and esmolol can also be used.\nSodium bicarbonate can be given for metabolic acidosis.\nPatients with unresponsive bupivacaine toxicity, intrvenous lipid or cardiopulmonary bypass may be considered.', 'role': 'assistant'}]