Comfortably Numb: Local Anesthetic Resistance In A Scheduled Caesarean Section
We present the case of a G1P0 non-obese patient undergoing a scheduled caesarian section with a self-reported history of needing large doses of local anesthetic (LA) at the dentist. Despite a standard spinal dosing, the patient only achieved an analgesic level to T10 and required a post-spinal epidural with significant additional dosing to achieve a suitable T4 level. Failure of local anesthetics has few explanations including technical error, localized infections, improper storage, and scorpion bites. True resistance is exceedingly rare and poorly understood, however proposed mechanisms include a wide spectrum of genetically defective sodium channels.
Reilly E, Neville S, Vrtar A. Comfortably numb: local anesthetic resistance in a scheduled caesarian section. Presented at: American Society of Anesthesiology Annual Meeting; 2022 Oct 21-25; New Orleans, LA.
American Society of Anesthesiology Annual Meeting, New Orleans, LA, October 21-25, 2022.