Which of the following sentences is true regarding local anesthetic systemic toxicity

A. Systemic toxicity is very common when used for lower extremity peripheral nerve blocks

B. A forceful, rapid injection of local anesthetic carries a higher risk of systemic local anesthetic toxicity

C. There are no case reports of toxicity following lumbar plexus and proximal sciatic blocks, while there are several cases reported after popliteal sciatic blockades

D. The risk of severe toxicity can be decreased if epinephrine is not used as an intravascular marker

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