EFFECT OF PREVIOUS SCORPION BITE ON THE EFFICACY OF INTRATHECALLY ADMINISTERED LEVOBUPIVACAINE IN SUBARACHNOID BLOCK

Abstract

Objectives: Local anesthetics administered by spinal anesthesia acts through sodium channels. Mutations of sodium channels may be responsible for resistance to local anesthetic agents. The scorpion venom contains neurotoxins that block the sodium channels. In view of the high prevalence of scorpion stings in our region and observation of failure of spinal anesthesia in patients with a history of scorpion stings in routine practice, the present study is planned. Methods: Forty patients of the American Society of Anesthesiologists Grade I or II who were undergoing infraumbilical surgery were divided into two groups as S (patients with h/o scorpion bite) and C (patients with no such history). The subarachnoid block was given with 3.2 ml of injection Levobupivacaine 0.5% heavy using 26 gauzes Quincke spinal needle. A blind observer recorded a sensory block using a needle prick and a motor block using the Bromage scale. Onset of sensory and motorized block, time to peak of sensory, and motor block and its relation to number of scorpion bites were observed in both the groups. Results: The onset of sensory (2.61±1.68 mins) and motor blockade (2.91±1.80 mins) was significantly delayed in Group S (p=0.010 and 0.004, respectively). Time to peak of sensory and motor blockade was also prolonged in Group S (6.45±2.83 mins and 7.8±3.95 mins) compared to Group C (3.60±0.84 mins and 4.56±1.30 mins) which was statistically significant (p<0.05). Patients who had previous scorpion bites (Group S) had a significant failure rate of spinal anesthesia compared to the control group. Conclusion: In this study, it was observed that the patients with scorpion bites had a significant failure rate of spinal anesthesia, suggesting probable resistance to the local anesthetic agents.