Successful Spinal Block in Obstetric Patient with Past History of Scorpion Sting and Failed Spinal Anesthesia

Association between local anesthestic resistance and scorpion sting have been reported in literatures. Scorpion venom is known to affect the sodium channels in the nerve fibres and local anesthetics also acts on the same. But we report a case of successful spinal block in 23 years old second gravida posted for elective caesarean section with past history of failed spinal block and multiple scorpion sting 7 years and 2 years back. Last exposure was 4 months before previous caesarean section, thus failed spinal block may be due to recent exposure. Our conclusion is that, there is a direct relationship between duration of exposure to scorpion venom and susceptibility to local anesthetics.

Scorpion Bite causing Acute Severe Myocarditis: A Rare Complication.

Scorpion bites are common in India as well as in other countries. Usually, these bites are harmless but sometime have serious clinical sequelae, including death. We report herein a case of scorpion bite that presented with acute severe myocarditis - a rare complication.

Análise de variáveis relacionadas à evolução letal do escorpionismo em crianças e adolescentes no estado de Minas Gerais no período de 2001 a 2005 / Analysis of variables related to fatal outcomes of scorpion envenomation in children and adolescents in the state of Minas Gerais, Brazil, from 2001 to 2005

OBJETIVOS: Descrever e avaliar os acidentes escorpiônicos notificados no estado de Minas Gerais, em crianças e adolescentes, no período de 2001 a 2005, e calcular incidência e mortalidade e identificar fatores relacionados à evolução para óbito. MÉTODOS: Estudo de 14.406 fichas de notificação obrigatória do escorpionismo em Minas Gerais, de pacientes de 0 a 19 anos. Após análise univariada, com fatores relacionados a mortalidade (p < 0,25), foi realizada regressão logística para análise multivariada. RESULTADOS: Houve aumento das notificações dos acidentes escorpiônicos ao longo dos anos. A faixa etária em que mais ocorreu acidente foi de 5 a 9 anos. Dor local esteve presente em 95 por cento dos casos. A maioria dos casos foi classificada como leve (60 por cento), com utilização do soro em 42 por cento dessa população. A letalidade média foi de 0,7 por cento. O município de maior ocorrência do acidente foi a capital Belo Horizonte. O atraso de cada 1 hora até o primeiro atendimento representou aumento de 9 por cento na razão de chance de evolução para óbito, que foi 46 vezes maior no grupo grave do que nos grupos moderado e leve. Para cada ano a menos na idade do paciente houve um aumento de 13 por cento na razão de chance de evolução para óbito. CONCLUSÕES: Houve aumento do número de notificações ao longo dos anos estudados. Foram identificados como fatores com maior razão de chance de evoluir para óbito: atraso para o primeiro atendimento, ser classificado como grave e menor idade.

OBJECTIVES: To describe and evaluate notified scorpion envenomation incidents in children and adolescents in the Brazilian state of Minas Gerais between 2001 and 2005, and to calculate the incidence and mortality and identify factors related to fatal outcomes. METHODS: Analysis of 14,406 mandatory notifications of scorpion envenomation involving patients aged 0 to 19 years in Minas Gerais. After performing a univariate analysis of factors related to mortality (p < 0.25), multivariate analysis was carried out using logistic regression. RESULTS: The number of notifications of accidents involving scorpions increased over the period. The age group that suffered most accidents was 5 to 9 years. Local pain was reported in 95 percent of cases. The majority of cases were classified as mild (60 percent) and antivenom was given to 42 percent of this population. The mean mortality rate was 0.7 percent. The state capital, Belo Horizonte, was the municipality with the greatest occurrence of incidents. Each hour's delay before receiving first medical care was associated with a 9 percent increase in the odds ratio for the likelihood of death, which was 46 times greater in the severe group than in the moderate and mild groups. A decrease of 1 year in patient age was associated with a 13 percent increase in the odds ratio for the likelihood of death. CONCLUSIONS: There was an increase in the number of notifications over the period studied. The following factors were identified as linked with a higher odds ratio for the likelihood of death: delayed first medical care, being classified as a severe case, and younger age of victim.