Hypothetical patient:

You get called by an anaesthetic registrar to come and help them with a woman in labour ward. They tell you that they have been struggling for a number of hours now to get a woman comfortable. They have placed three epidurals and topped them up aggressively with generous doses of the usual bupivacaine and fentanyl medications but none of them seem to have been effective. The woman told them that she has had similar problems in the past with dental procedures and minor skin procedures when younger - she also states she has Ehlers-Danlos syndrome.

Hi Everyone,

This week I am joined by Fionn - a WA anaesthetic trainee currently working with us here. We discuss the fascinating (but distressing) syndrome of resistance to local anaesthetics.

Is it real? (yes)

How common is it - and what do we know about it?

LINKS

https://www.bbc.com/future/article/20170106-the-people-who-cant-go-numb-at-the-dentists

https://www.hypermobility.org/local-anaesthetic

Resistance to local anesthesia in people with the Ehlers-Danlos Syndromes presenting for dental surgery