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Archived Comments for: Local anesthetic resistance in a pregnant patient with lumbosacral plexopathy

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  1. Causes of local resistance.

    Adrian Woollard, North East Wales NHS Trust

    18 June 2007

    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