Musgrove nurse launches study into rare but dangerous anaesthetic risk

A theatre nurse at Musgrove Park Hospital has launched a project to tackle a potentially life-threatening condition after noticing gaps in colleagues’ knowledge on the ground.

Adeola Adebisi, who has worked in operating theatres at MPH since 2022, is exploring how well colleagues understand local anaesthetic systemic toxicity (LAST), as part of the Chief Nurse Research Fellowship.

The condition, while rare, can have serious consequences for patients if not recognised quickly – something Adeola said first became apparent through her day-to-day experience in theatre.

“I’ve been a nurse for the past eight years, and I previously worked in Nigeria for some years, before moving to Musgrove Park Hospital in 2022,” she says.

“Ever since then I’ve been working in our operating theatres as a staff nurse and theatre practitioner, and so far I’m really enjoying it.

“In early 2025 I heard all about the Chief Nurse Research Fellowship, which caught my interest immediately, so I decided to apply for it.

“It has really increased my curiosity, and it has also shown me a different pathway from my clinical practice, which I have been enjoying so far.”

Her project focuses on local anaesthetic systemic toxicity – a condition caused by high levels of local anaesthetic in the bloodstream, affecting both the central nervous system and cardiovascular system.

While anaesthetists are responsible for administering anaesthetic drugs, Adeola says theatre teams are often the first to spot when something isn’t right.

“The thing that prompted me to carry out this project is because in recent times, over almost four years that I’ve been working in theatre, there has been some discussion between the nurses and surgeons about the difference in doses,” she says.

“For example, we may have a patient who ends up having a tachycardia distress, and we can see on the monitor that they have those symptoms.

“As nurses we don’t give anaesthetic, as that’s the role of the anaesthetist doctors, but sometimes we realise that we don’t actually know what to do.”

She says a lack of awareness around the signs and symptoms of LAST can leave colleagues feeling unsure in critical moments.

“Most of us don’t know the signs and symptoms of local anaesthesia systemic toxicity, often because the patient doesn’t really show symptoms,” she says.

“But at other times it could be that the blood pressure is high and the heart rate high, all of which show that something must be wrong somewhere.

“As we don’t have this knowledge, as nurses we won’t know what to do when this happens, and that has been a constant issue with particular procedures.”

Through her early findings, Adeola believes the issue is more widespread than many might expect.

“I realised that this was a problem that needs to be solved and through my project I’ve realised that a lot of nurses don’t actually know what to do, or what the symptoms are,” she says.

“That’s because they don’t actually administer the anaesthetic themselves, so there’s a thought process that they don’t need to know.”

Alongside improving awareness of LAST, Adeola said her wider ambition is to use research to drive improvements in theatre efficiency and patient experience more broadly, particularly around reducing waiting times.

“In recent times I’ve had the opportunity to interact with colleagues in my service area and observe different aspects of care that require improvement,” she says.

“One of the things that really stands out to me is reducing patient waiting lists by introducing more flexible working and multiskilling.

“For instance, a scrub practitioner could also be trained in anaesthesia or recovery, so there are always the right skills available across the team.

“That would foster teamwork, improve efficiency and help reduce cancellations, which is one of the major challenges of the NHS.”

She adds that developing a more flexible, highly skilled workforce could also help theatres run more consistently.

“If we had more flexible shifts and multiskilled colleagues, there wouldn’t be shortages in one area of the theatre compared to another,” she says.

“It would help ensure more procedures go ahead as planned and ultimately reduce the number of patients waiting for surgery.”

Adeola said her passion for research began during her university training, where she carried out a study on hepatitis B in childbearing women in her community, something that continues to shape her approach today.

“In order to make meaningful change in clinical practice, we need evidence-based practice from research that provides clear outcomes and recommendations,” she says.

“That evidence can then be shared with colleagues and students so they can practise more effectively and with understanding.”

She hopes her current project will play a key role in improving patient safety by helping colleagues feel more confident in recognising and responding to early warning signs of LAST.

“I think my project will benefit patients a lot because to carry out patient-centred care is very important,” she says.

“We have to understand that no two patients are the same, even if they have the same diagnosis and symptoms, their reactions to medications are different.

“For instance, when you give some patients local anaesthesia, some of them don’t even react to the injection pain, whereas others may shout and be in distress.”

She says a stronger understanding of safe dosing and patient-specific factors, such as weight, age and underlying conditions, would support more consistent, evidence-based care.

“For the benefit of patients, we need a better understanding of what the maximum dose is for that particular patient, based on their weight, age and medical conditions,” she says.

“It will help us to carry out evidence-based practices in the theatre.”

Alongside her clinical work, Adeola also serves as a Freedom to Speak Up Ambassador within the operating theatres, and said the fellowship is helping her develop the skills to lead change.

“I am passionate about creating change that provides better patient outcomes and good colleague wellbeing,” she says.

Looking ahead, she will begin analysing the data from her study to build a clearer picture of current knowledge levels across the workforce.

“The next step for my project will be analysing the data once I have enough responses,” she says.

“It should help us to know what level of knowledge colleagues have on local anaesthesia systemic toxicity.”