Panditrao Mridul M, Panditrao Minnu M, Sunilkumar V, Panditrao Aditi M
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. 2013 May;57(3):236-40. doi: 10.4103/0019-5049.115593.
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.
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.
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.
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.
在该机构的日常工作中，观察到有蝎子蜇伤史的患者中持续出现脊髓麻醉不足/失败的情况。为了检验蝎子蜇伤与脊髓麻醉反应改变之间的可能相关性，进行了一项病例对照研究，纳入有蝎子蜇伤史和无蝎子蜇伤史的患者。
随机选取70例年龄在18 - 80岁的男女患者，分为两组，一组有一次或多次蝎子蜇伤史，另一组无此类病史。麻醉管理相同，包括蛛网膜下腔阻滞，使用3.5毫升0.5%重比重布比卡因。采用针刺法和 Bromage 评分法观察感觉、运动阻滞的起效时间以及感觉和运动阻滞的峰值。等待20分钟后，如果阻滞不足，则给予平衡全身麻醉。使用卡方检验、百分比、独立样本t检验和配对t检验进行数据分析和各种统计检验。
两组在人口统计学上具有可比性。在蝎子蜇伤组，感觉和运动阻滞的起效时间以及感觉和运动阻滞的峰值时间均显著延长，4例患者感觉阻滞失败/不足，5例患者运动阻滞失败/不足，而无蜇伤组的所有患者术中阻滞均充分。
我们得出结论，既往有单次或多次蝎子蜇伤史与鞘内注射局部麻醉药效果的耐受性之间似乎存在直接相关性。
