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Background and Aims A 20% intravenous lipid emulsion (ILE) entraps the lipophilic local anaesthetics and has been useful in managing its systemic toxicity. We hypothesize that ILE can reverse the effects of spinal anaesthesia with the same mechanism.

Methods This was a randomized double-blinded controlled trial, sixty patients, aged >18 years were recruited; the ILE group (n = 29) received ILE (1.5 ml/kg bolus followed by 0.25 ml/kg/hr infusion over 30 minutes), and the control group (n = 31), an equal volume of normal saline at the end of surgery. The outcomes measured were: time for 1 and 2-segment sensory regression and time for complete motor and sensory regression from the time of administering study drugs.

Results The demographic profile of patients were comparable in both groups. One segment sensory regression (21.72 ± 2.33 min versus 29.03 ± 2.56 min, p-value <0.001) and 2 segments sensory regression (43.45 ± 4.65 min versus 58.1± 5.11 min, p-value <0.001) were significantly faster in patients who received ILE. Complete sensory recovery (200.69 ± 19.81 min versus 237.1 ± 17.93 min, p-value <0.001) and motor recovery (157.76 ± 13.1 min versus 193.55 ± 23.03 min, p-value <0.001) were significantly faster in the ILE group from the end of surgical procedure.

Conclusions A 20% ILE significantly reversed the spinal anaesthesia in terms of faster sensory and motor recovery as compared to the control group. Our results encourage the use of ILE in situations like high or total spinal anaesthesia; however, more studies with larger sample sizes are recommended.