Scorpion Sting: A Reason for Failed Local Anesthetic Action
Kajal S Dalal, Shrividya Chellam, Pratibha V Toal, Shweta Panse
Keywords :
Case report, Failed local anesthesia, Local anesthesia resistance, Scorpion sting, Spinal anesthesia failure
Citation Information :
Dalal KS, Chellam S, Toal PV, Panse S. Scorpion Sting: A Reason for Failed Local Anesthetic Action. Res Inno Anesth 2023; 8 (2):57-59.
Failed action of local anesthetics can be due to technical errors, but resistance to local anesthetic agents can also be a reason. Scorpion venom has the potential to cause antibodies to local anesthetics and genetic mutations in the receptors resulting in local anesthesia resistance.
We would like to report two cases with a history of scorpion stings in the past where resistance to local anesthetic agents was seen. Local anesthesia resistance can be manifested as inadequate block or block failure. In such cases, the anesthesiologist should keep a history of scorpion bite in mind in areas where scorpion sting is common. Eliciting the history of scorpion bites should be a part of the routine preoperative protocol in areas where scorpion bites are frequent.
Panditrao MM, Panditrao MM, Sunilkumar V, et al. Effect of previous scorpion bite(s) on the action of intrathecal bupivacaine: a case control study. Indian J Anaesth 2013;57(3):236–240. DOI: 10.4103/0019-5049.115593
Panditrao MM, Panditrao AM, Panditrao BI. Single or multiple previous scorpion bites can lead to development of resistance to the effect of local anesthetic drugs administered via various routes: reporting a yet unrecognized phenomenon. Anaesthesiologist 2015;1:10–15.
Bawaskar HS, Bawaskar PH. Indian red scorpion envenoming. Indian J Pediatr 1998;65(3):383–391. DOI: 10.1007/BF02761131
Kosam D, Nigam R, Murthy M, et al. Effect of previous scorpion sting on the efficacy of spinal anesthesia - a case control study. Int J Med Res Rev 2015;3(8):826–831. DOI: 10.17511/ijmrr.2015.i8.155
Ragsdale DS, McPhee JC, Scheuer T, et al. Molecular determinants of state-dependent block of Na+ channels by local anesthetics. Science 1994;265(5179):1724–1728. DOI: 10.1126/science.8085162
Gokulakrishnan G, Umamageshwaran P. Scorpion sting and spinal anaesthesia-a rare case report. Int J Appl Res 2019;9(11):50–51. DOI: 10.36106/ijar
Cestèle S, Catterall WA. Molecular mechanisms of neurotoxin action on voltage-gated sodium channels. Biochimie 2000;82(9–10):883–892. DOI: 10.1016/s0300-9084(00)01174-3
John Varghese R, Dhulkhed V. B187 successful outcome of spinal anaesthesia in a patient with a history of scorpion sting and failed spinal anaesthesia. Reg Anesth Pain Med 2022;47(Suppl 1):A174. DOI: 10.1136/rapm-2022-ESRA.262
Panditrao MM, Khan MI, Yadav N. Does scorpion bite lead to development of resistance to the effect of local anaesthetics? Indian J Anaesth 2012;56:575–578. DOI: 10.4103/0019-5049.104582
