Regional Anesthesia for Symptomatic Treatment of Stingray Envenomation

Abstract

Stingray envenomation is common in coastal regions around the world and may result in intense pain that can be challenging to manage. Described therapies involve hot water immersion and potentially other options such as opioid and nonopioid analgesics, removal of the foreign body, wound debridement, antibiotics for secondary infection, and tetanus toxoid. However, for some patients, this may not be enough. Peripheral nerve blockade is a frequently used perioperative analgesic technique, but it has rarely been described in the management of stingray envenomation. Here, we report a case of stingray envenomation in an otherwise healthy 36-y-old male with pain refractory to traditional therapies. After admission for pain control, the patient received an ultrasound-guided sciatic popliteal nerve block. Upon completion of the peripheral nerve block, the patient reported rapid and complete resolution of the intense pain, which did not return thereafter.

Marine Envenomation in Okinawa: Overview and Treatment Concept

“…38 Regional anesthesia may be considered for symptomatic control of painful extremities. 39 Magnesium has been recommended as a therapy based on its potential to decrease catecholamine activity after envenomation, although the overall benefit is not clear. 40 Because of the sympathomimetic toxidrome that can occur, the patient should be evaluated for hemodynamic changes and a hyperdynamic state.…”

A Randomized Trial Comparing Intravenous Paracetamol, Topical Lidocaine, and Ice Application for Treatment of Pain Associated with Scorpion Stings: Some Concerns

“…Peripheral nerve blocks are gaining increasing acceptance and popularity in the emergency department to provide pain relief from various animal bites and venomous snake bites. 9,10 In our experience, ultrasound-guided selective sensory peripheral nerve blocks, such as superficial radial nerve blocks or superficial peroneal nerve blocks, can be achieved with a small amount (1–2 mL) of local anesthesia, without the loss of motor functions, and, in such small volumes, are devoid of systemic side effects. 11 If pain recurs, the block can be easily repeated because it is superficial.…”