Dr. G. Gokulakrishnan, Dr. P. Umamageshwaran


INTRODUCTION: Spinal anaesthesia is a preferred technique used for lower abdominal and lower limb surgeries. A
“failure of subarachnoid block” may be due to various reasons, one of which is a resistance to local anaesthetics. This
resistance to local anaesthetic is difficult to diagnose. One might miss to elicit a history of scorpion sting in the pre-operative evaluation. Here we
report one such case where spinal anaesthesia was administered and later upon noticing a failed block, a history of scorpion sting was elicited in
operating room.
PRESENTATION: A 47 yr old man following trauma, suspected to have scrotal haematoma was planned for emergency scrotal exploration and
evacuation of haematoma. He was assessed under ASA-IE and spinal anaesthesia was planned. Spinal anaesthesia was administered by an
experienced anaesthesiologist, it was found to be a “failure of block”. A repeat spinal was given which again failed to take up. A history of
scorpion sting was then elicited. Balanced general anaesthesia was administered and surgery was performed uneventful.
SUMMARY: The time of onsets of both sensory and motor blocks and time for the peak of sensory and motor blocks are significantly prolonged
and in some cases there is total failure. The resistance to local anaesthetics is noted even in other routes of administration.
CONCLUSION: Patients with a history of scorpion bite exhibited apparent resistance to bupivacaine spinal block. This resistance manifested as
inadequate block or block failure requiring conversion to general anaesthesia.


Scorpion Sting, Local Anaesthetic Resistance, Spinal Anaesthesia

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