We recently reported several cases consistent with transient radicular
irritation after spinal anesthesia with hyperbaric 5% lidocaine. The
present prospective, blind, nonrandomized study was performed to deter
mine the incidence of these transient neurologic symptoms and to ident
ify factors that might be associated with their occurrence. We studied
270 patients scheduled for gynecologic or obstetric procedures under
spinal anesthesia. For spinal anesthesia, either 5% lidocaine in 7.5%
glucose or 0.5% bupivacaine in 8.5% glucose was used. Patients were ev
aluated on postoperative day 3 by a quality assurance nurse who was un
aware of the drug given or details of the anesthetic technique. Transi
ent neurologic symptoms were observed in 37% of patients receiving 5%
lidocaine, whereas only one patient receiving 0.5% bupivacaine had tra
nsient hypesthesia of the lateral aspect of the right foot, These resu
lts suggest that symptoms were the result of a specific drug effect. H
owever, because of the limitations of the study one cannot conclude th
at lidocaine per se was the cause.