Email updates

Keep up to date with the latest news and content from BMC Anesthesiology and BioMed Central.

Open Access Highly Accessed Open Badges Case report

Local anesthetic resistance in a pregnant patient with lumbosacral plexopathy

Renae Kavlock and Paul H Ting*

BMC Anesthesiology 2004, 4:1  doi:10.1186/1471-2253-4-1

PubMed Commons is an experimental system of commenting on PubMed abstracts, introduced in October 2013. Comments are displayed on the abstract page, but during the initial closed pilot, only registered users can read or post comments. Any researcher who is listed as an author of an article indexed by PubMed is entitled to participate in the pilot. If you would like to participate and need an invitation, please email, giving the PubMed ID of an article on which you are an author. For more information, see the PubMed Commons FAQ.

Causes of local resistance.

Adrian Woollard   (2007-06-18 11:42)  North East Wales NHS Trust email

Dear Authors

I thought your article was well written. We have recently had a similar case of local anaesthetic resistance. It was a patient presenting as an emergency for a caesarean section. The patient had a history of failure of local anaesthetics for dental procedures and dermatological procedures. The spinal also failed despite good practice. We never found a reason for it to fail. Other reasons we suspect would include subarchnoid cysts which although rare in the lumbar regional could explain the aspiration of CSF and the ability to inject 2 mls without detectable resistance. A review article in the BJA could explain where a mutation in the channel would cause resistance to local anaesthetics. It would be interesting to find the incidence of failure to produce a spinal despite the end point of aspiration of CSF.


A Scholz. Mechanisms of local anaesthetics on voltage-gated sodium and other ion channels British journal of anaesthesia 2002;89:52-61

Competing interests



Post a comment