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Resistance to local anesthetics: Truth or myth?
A Brito1, M Pinto1, Z Moreira1
1Anestesiología, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Revista Espanola De Anestesiologia Y Reanimacion
|March 19, 2023
Summary
Anesthetic technique failure may stem from rare local anesthetic resistance. Genetic testing and evaluating alternative anesthetics offer a novel diagnostic approach for suspected resistance.
Area of Science:
- Anesthesiology
- Pharmacogenetics
Background:
- Anesthetic technique failure necessitates etiological investigation.
- Locoregional anesthesia failure requires thorough assessment to rule out common causes.
Observation:
- A case of locoregional anesthesia failure was investigated.
- Common causes were excluded, leading to the hypothesis of local anesthetic resistance.
- Genetic testing and evaluation of alternative local anesthetics were performed.
Findings:
- True resistance to local anesthetics is challenging to diagnose and infrequently documented.
- Mutations in sodium channels, the binding site for local anesthetics, are a proposed cause.
- Unrecognized resistance can lead to adverse events and toxic local anesthetic exposure.
Implications:
- Suspected local anesthetic resistance should be investigated through genetic testing and alternative anesthetic trials.
- This diagnostic approach may improve patient safety and outcomes in cases of unexplained anesthetic failure.
- Early recognition of local anesthetic resistance is crucial to prevent complications and ensure effective pain management.
Keywords:
Anestesia obstétricaAnestesia regionalAnestésicos localesLocal anestheticsObstetrical anesthesiaRegional anesthesiaMore Related Videos
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