[Stonefish stings: difficult analgesia and notable risk of complications].
BACKGROUND
Marine activities and water sports in tropical countries entail some dangers. In our emergency department, stonefish (Synancae verrucosa) stings are second only to those by sea urchins among the 400 consultations a year for wounds by marine animals.


METHODS
We retrospectively collected data for all emergency department visits for stonefish stings over a 5-year period from 2001 through 2005.


RESULTS
The study included 57 patients (42 men; mean age 31.2+/-15.9 years, range 3-63 years) at 61 consultations. The reason for the emergency department visit was pain, often described as intense. Injuries occurred to the foot in 79% of cases and the hand in 21%. Local signs included a wound (100%), edema (74%), local inflammation (21%), bruising (23%), necrosis (19%), and, in one patient, cellulitis. Pain was reported in 95% of cases. Local care consisted of immersing the stung area in hot water (79%) or in situ lidocaine injection (16%). Analgesics were administered in 75% of the cases, including morphine (54%) and anti-inflammatory drugs in 47%. Other analgesic techniques included ketamine (3.5%), nitrous oxide (3.5%), and local or regional anesthesia (3.5%); 29% of patients received antibiotics. Patients requiring admission (46%) differed from those who did not by a need for more intense analgesia and by greater wound inflammation and necrosis. Three patients required surgery and three others, hyperbaric oxygen therapy.


CONCLUSIONS
Stonefish stings present the risk of local complications. Analgesia is also a major concern for emergency physicians and prophylactic antibiotics must be considered.
Grandcolas
Nadège
N
Service des urgences-SMUR-OHB, Groupe hospitalier Sud Réunion, F-97448 St Pierre Cedex, La Réunion.
Galéa
Julie
J
Ananda
Ramou
R
Rakotoson
Rolland
R
D'Andréa
Cyril
C
Harms
Jan Dirk
JD
Staikowsky
Frédérik
F
D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001733:Bites and Stings / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D005399:Fishes; D006801:Humans; D006931:Hyperbaric Oxygenation; D007101:Immersion; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D059408:Pain Management; D012189:Retrospective Studies
D000700:Analgesics; D000900:Anti-Bacterial Agents