Can repeated scorpion bite lead to development of resistance to the effect of local anesthetics?  Maybe it does!

Panditrao, Mridul M; Panditrao, Minnu M; Sunilkumar, V.; Panditrao, Aditi

doi:10.4236/crcm.2013.22049

Cited by 5 publications

(7 citation statements)

References 10 publications

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“…We have come across with apparent “resistance” in quite a few patients with history of single or multiple scorpion bites, where the local anaesthetics had been administered via different routes such as spinal, epidural, supraclavicular brachial plexus block and peribulbar block. [721] The failure of local infiltration with local anaesthetics, highlights the possibility of development of ‘resistance’ to local anaesthetics in patients with scorpion bite history and is consistent with the failures of spinal block presented in the present study.…”

Section: Discussionsupporting

confidence: 87%

Effect of previous scorpion bite(s) on the action of intrathecal bupivacaine: A case control study

Panditrao

Sunilkumar

et al. 2013

Indian J Anaesth

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Background:During the routine practice in the institution, it was observed that there were persistent incidents of inadequate/failed spinal anaesthesia in patients with a history of single or multiple scorpion bite/s. To test any possible correlation between scorpion bite and the altered response to spinal anaesthesia, a case control study was conducted involving patients with a history of scorpion bite/s and without such a history.Methods:Randomly selected 70 (n=70) patients of either sex and age range of 18-80 years, were divided into two equal groups, giving past history of one or multiple scorpion bites and giving no such a history. The anaesthetic management was identical inclusive of subarachnoid block with 3.5 ml. 0.5% bupivacaine heavy. The onsets of sensory, motor and peaks of sensory and motor blocks were observed with the pin-prick method and Bromage scale. After waiting for 20 min, if the block was inadequate, then balanced general anaesthesia was administered. The analysis of the data and application of various statistical tests was carried out using Chi-square test, percentages, independent sample t-test and paired t-test.Results:Demographically both groups were comparable. In scorpion bite group, the time of onsets of both sensory and motor blocks and time for the peak of sensory and motor blocks were significantly prolonged, 4 patients had failed/inadequate sensory block and 5 patients had failed/inadequate motor block while all the patients in non-bite group had adequate intra-operative block.Conclusion:We conclude that there appears to be a direct correlation between the histories of old, single or multiple scorpion bites and development of resistance to effect of local anaesthetics administered intra-thecally.

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Section: Discussionsupporting

confidence: 87%

Effect of previous scorpion bite(s) on the action of intrathecal bupivacaine: A case control study

Panditrao

Sunilkumar

et al. 2013

Indian J Anaesth

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“…The more the number of bites or more recent the bites, more the extent of failure of the block. The patients with maximum number of bites (3)(4) and that also in the most recent past, had almost complete failure of the block.…”

Section: Discussionmentioning

confidence: 97%

“…Even after doing so, only partial and patchy/ineffective block was achieved and surgery had to be completed under supplemental intravenous sedation and opioid analgesia [3]. In the post-operative period, patient gave past history of scorpion bite three times, at the age of 27 years on his right foot, another 8-9 years back and last, 6-7 months back on his right hand.…”

Section: Background Informationmentioning

confidence: 99%

“…There are reports of "not able to achieve" the adequate sensory/motor effect when local anesthetic is administered either via neuraxial route, for peripheral/ regional nerve blocks or as local infiltration, where, because of lack of any substantial and sustainable explanation, the inability to achieve the block had to be attributed to the so-called "resistance to, or failure of effect of local anesthetics" [1][2][3]. Resistance to the effect of local anesthetic agents is an uncommon but not an unknown phenomenon.…”

Section: Introductionmentioning

confidence: 99%

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Development of Resistance to the Effect of Local Anesthetic Agents Administered Via Various Routes Due to Single or Multiple, Previous Scorpion Bites: A Proposed Hypothesis and Reporting a Yet Unrecognized Phenomenon

Panditrao¹

2015

JACCOA

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“…Mostly our study results can also be attributed to the antagonism at the binding site [9][10][11][12][13][14] . However, many authors attribute antagonism as one of the important factor for the failure but, more research at the molecular level has to be conducted to find out the exact cause of failure of anesthesia [15][16] .…”

Section: Discussionmentioning

confidence: 99%

Local Anesthesia Failure Cases with Scorpion Bite History in Third Molar Surgery- A Challenge

2017

ARC Journal of Anesthesiology

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Patients planned for third molar surgery who were administered conventional intraoral mandibular nerve block were considered. Local anesthesia failure in third molar surgery can be attributed to many causes but, failure due to history of scorpion bite was not reported in the literature in oral and maxillofacial surgeries. On the operative day after obtaining informed consent, local infiltration of the skin on the ventral aspect of the forearm, using, 6 ml, 2% lignocaine with adrenaline, was carried out. Confirming the suspicion, there was no sensory block after the injection, confirmed by pin prick method. Cases reported in the literature were due to failure of spinal anesthesia but not in third molar surgery the female patients also gave a history of spinal anesthesia failure during their deliveries and were operated under general anesthesia.

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Can repeated scorpion bite lead to development of resistance to the effect of local anesthetics? Maybe it does!

Cited by 5 publications

References 10 publications

Effect of previous scorpion bite(s) on the action of intrathecal bupivacaine: A case control study

Effect of previous scorpion bite(s) on the action of intrathecal bupivacaine: A case control study

Development of Resistance to the Effect of Local Anesthetic Agents Administered Via Various Routes Due to Single or Multiple, Previous Scorpion Bites: A Proposed Hypothesis and Reporting a Yet Unrecognized Phenomenon

Local Anesthesia Failure Cases with Scorpion Bite History in Third Molar Surgery- A Challenge

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