ANESTHETIC IMPLICATION OF SNAKE-BITE ENVENOMATION

Although there are many articles on snakebite envenomation, few addres s the anesthetic implications of this potentially serious disease. (1) The reported incidence of snakebite in the human population is approx imately 45,000 cases/yr in the United States. Poisonous envenomation c omprises 8000 cases/yr with a mortality of 0.2% and long-term morbidit y of 11%. (2) Two indigenous families of snakes are considered venomou s in the United States. The Elapidae family contains the coral snakes and the Viperidae (subfamily: Crotalidae) contains the copperheads, co tton mouths, and rattlesnakes. Systemic manifestations of toxicity are rare with copperheads and recommended guidelines for therapy are dire cted at local wound care (3,4). In our patient, a severe envenomation by a species (Agkistrodon contortrix [copperhead]) considered benign w as associated with prolonged neuromuscular blockade.