A 22-year-old patient begins convulsing immediately after local anesthetic administration. What is the most appropriate treatment for local anesthetic-induced seizures?

Convulsions following local anesthetic administration represent local anesthetic systemic toxicity (LAST), specifically CNS toxicity from excessive plasma concentrations of the anesthetic. Initial management includes: stopping the anesthetic, maintaining airway, administering oxygen, activating EMS, and administering an anticonvulsant. Benzodiazepines (IV/IM midazolam or diazepam) are the agents of choice to terminate LAST-induced seizures. Lipid emulsion therapy (20% intralipid) is used for cardiovascular collapse from LAST. Phentolamine reverses soft tissue anesthesia duration but does not treat seizures. Compresses and massage have no role in LAST management.