Panditrao Minnu Mridul, Panditrao Mridul Madhav, Khan Mohd Irfan, Yadav Nikhil
Department of Anaesthesiology and Intensive Care, Padmashree Dr. Vithalrao Vikhe Patil Foundation's Medical College and Hospital, Vilad Ghat, Ahmednagar, Maharashtra, India.
Indian J Anaesth. 2012 Nov;56(6):575-8. doi: 10.4103/0019-5049.104582.
A patient posted for vaginal hysterectomy was administered subarachnoid block, which failed, so was repeated in one space above. The block failed again, after waiting for 30 min. Patient gave a history of scorpion bite twice, once at the age of 17 years on her right foot and again about 8 months back. Thereafter, balanced general anaesthesia was given. On eighth post-operative day, after explaining about her possible special condition (?Resistance to local anaesthetic agents), the patient was given left median, ulnar and radial nerve blocks at the wrist and local infiltration near the anatomical snuff box. There was neither sensory nor motor block. The scorpion venom is known to affect the pumping mechanism of sodium channels in the nerve fibres, which are involved in the mechanism of action of local anaesthetic drugs, it may be responsible for the development of 'resistance' to the action of local anaesthetic agents.
一名计划进行阴道子宫切除术的患者接受了蛛网膜下腔阻滞，但阻滞失败，于是在更高一个间隙重复进行。等待30分钟后，阻滞再次失败。患者有两次被蝎子蜇伤的病史，一次是17岁时右脚被蜇，另一次约在8个月前。此后，给予了平衡全身麻醉。术后第八天，在向患者解释了她可能存在的特殊情况（？对局部麻醉药耐药）后，对患者进行了腕部左侧正中神经、尺神经和桡神经阻滞以及鼻烟壶附近的局部浸润。既没有感觉阻滞也没有运动阻滞。已知蝎毒会影响神经纤维中钠通道的泵浦机制，而钠通道参与局部麻醉药的作用机制，这可能是导致对局部麻醉药作用产生“耐药”的原因。
