We describe the clinical course and outcome in 46 victims of severe scorpion envenoming treated with prazosin (P), and compare them with earlier patients treated with conventional therapy (C) (n = 45) and nifepidine (N) (n = 28). The incidence of complicating left ventricular failure was 29 for C, 35 for N and 6.5 for P; that of acute pulmonary oedema was 46 for C, 14 for N and zero for P; mortality was 25 for C, 3.5 for N and zero for P. Although this is a historical study, prazosin appears to significantly reduce morbidity and shorten recovery time. Experience in other countries suggests that anti-venom is helpful in controlling many of these problems, but in rural India serotherapy remains largely unavailable, and prazosin is a mainstay of treatment.
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