Local anesthetics should be employed by clinicians who are well versed in diagnosis and management of dose-related toxicity and other acute emergencies which might arise from the block to be employed, and immediate availability of oxygen, other resuscitative drugs, cardiopulmonary resuscitative equipment, and personnel resources needed for proper management of toxic reaction and related emergencies. Delay in the proper management of dose-related toxicity, underventilation from any cause and/or altered sensitivity may lead to the development of acidosis, cardiac arrest, and possibly death.