Effect of previous scorpion sting on the efficacy of spinal anesthesia - A case control study

Kosam, D.; Nigam, Rakesh; Murthy, Madhumita; Debbarma, Miltan; Chatterjee, Sudarshana

doi:10.17511/ijmrr.2015.i8.155

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…They concluded, the effect of scorpion sting on spinal anesthesia is more pronounced in recent bites and gradually wanes off after 12 months. 12 Panditrao et.al, in their prospective, case control study involving 70 patients, on effect of previous scorpion bite(s) on the action of intrathecal bupivacaine noted that history of multiple and recent scorpion bites (less than 8 months) was associated with complete failure of the spinal block and required general anesthesia whereas patients with scorpion bites older than a year showed delayed onset for sensory block or the motor block or both. 13 Other causes for local anesthetic resistance like genetic A572D mutation in the SCN5A gene encoding for Nav1.5, type III Ehler Danlos Syndrome and redheads are rare but have been documented.…”

Section: Discussionmentioning

confidence: 99%

Scorpion Envenomation: The Cause of Inadequate Subarachnoid Block - A Case Series

Pakhare,

Nanda,

Priyanka

et al. 2023

JAP

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Background: Failure of neuraxial or regional anaesthesia can result from factors such as drug errors, technical inefficiencies, and poor patient positioning. While these causes are well-known, resistance to local anaesthetic action due to mutations in sodium channels or scorpion sting is a lesser-known contributor to block failure. In India, a tropical country with a significant number of patients presenting for surgical procedures, a history of scorpion bites is not uncommon. Case: We observed seven cases of failed regional anesthesia who had history of scorpion sting. All the patients received intrathecal bupivacaine by experienced anesthesiologists, of seven patients five patients did not develop sensory or motor block. One patient had delayed successful subarachnoid block after second attempt and one patient had successful block at first attempt. Conclusion: Our observations revealed instances of failed spinal blocks, despite adequate drug dosages and experienced anesthesiologists performing the procedures, in patients with a history of scorpion envenomation. Accordingly, our study concludes that obtaining a thorough scorpion sting history during pre-anesthesia check-ups, particularly in endemic areas, can effectively prevent unnecessary repeated pinpricks, escalating dosages, patient and surgeon discomfort, and skepticism towards the skills of anesthesiologists.

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Section: Discussionmentioning

confidence: 99%

Scorpion Envenomation: The Cause of Inadequate Subarachnoid Block - A Case Series

Pakhare,

Nanda,

Priyanka

et al. 2023

JAP

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Scorpion Sting: A Reason for Failed Local Anesthetic Action

Chellam,

Toal,

Dalal

et al. 2023

Journal of Research &Amp; Innovation in Anesthesia

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Do Previous Multiple Scorpion Bites Produce Resistance to Local Anesthetics Administered Via Repeated Subarachnoid and Epidural Blocks? A Case Report and Review of Available Evidence

Panditrao,

Madhekar,

Kenchey

et al. 2024

J Arch Mil Med

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Introduction: Failure to achieve a subarachnoid block, even after a second attempt, and the inability to activate epidural analgesia, despite a properly placed catheter, can be both frustrating and perplexing. This case presents a situation where these incidents occurred, and two well-conducted attempts at a subarachnoid block and a properly placed epidural catheter block were unable to produce surgical anesthesia. Case Presentation: A 55-year-old female, classified as American Society of Anesthesiologists (ASA) grade II, was scheduled for a total abdominal hysterectomy with bilateral salpingo-oophorectomy. After adequate pre-operative preparation, an epidural catheter was inserted on the morning of surgery, followed by a subarachnoid block with all the proper precautions, which completely failed. After waiting for 10 minutes, the epidural block was activated with a local anesthetic mixture. To our surprise, it also did not produce any desirable effect, so the subarachnoid block was repeated, which again failed to produce any clinical block. Consequently, the surgery had to be conducted under balanced general anesthesia. Recalling previous experience and evidence, a history of scorpion bites was elicited. The patient had a history of multiple encounters (five) and was from a geographical area known to be endemic for scorpions. Conclusions: This case represents another instance of developing resistance to the effects of local anesthetics after exposure to scorpion venom. We believe there is a strong correlation between previous scorpion bites, the number of bites, and the duration between the most recent bite and the development of resistance to local anesthetic agents (LAAs). From a detailed search, it was evident that enough clinical evidence has emerged to irrefutably support this proposal.

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Effect of previous scorpion sting on the efficacy of spinal anesthesia - A case control study

Cited by 3 publications

References 11 publications

Scorpion Envenomation: The Cause of Inadequate Subarachnoid Block - A Case Series

Scorpion Envenomation: The Cause of Inadequate Subarachnoid Block - A Case Series

Scorpion Sting: A Reason for Failed Local Anesthetic Action

Do Previous Multiple Scorpion Bites Produce Resistance to Local Anesthetics Administered Via Repeated Subarachnoid and Epidural Blocks? A Case Report and Review of Available Evidence

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