TRANSIENT RADICULAR IRRITATION AFTER BUPIVACAINE SPINAL-ANESTHESIA

Background and Objectives. Transient radicular irritation (TRI) has be en described to occur following spinal anesthesia with hyperbaric 5% l idocaine. The authors recently used only isobaric or hyperbaric 0.5% b upivacaine for spinal anesthesia. All patients who had spinal anesthes ia for various kinds of surgery were interviewed after the operation t o discover the possibility of TRI following bupivacaine spinal anesthe sia. Methods. The study included 226 patients. Isobaric 0.5% bupivacai ne was given to 116 patients and hyperbaric 0.5% bupivacaine to 110. T he local anesthetic was chosen according to the expected duration of s urgery. All patients were interviewed by an anesthesiologist 24 hours after spinal anesthesia, and after 1 week the patients were asked to r eturn a written questionnaire. If pain not associated with operation w as noted, the patients were interviewed by phone. Results. One 48-year -old woman reported TRI after spinal anesthesia (saddle block) with hy perbaric 0.5% bupivacaine in the 24-hour interview. Her spinal anesthe tic was performed in a sitting position and the anal surgery in a lith otomy position. In the 1-week questionnaire (response rate 92%), none of the other patients fulfilled our criteria for TRI. Conclusions. In spite of one case of TRI, the authors consider bupivacaine to be safe for spinal anesthesia. The association of the sitting and lithotomy po sitions to the restricted distribution of hyperbaric solution and cons equent TRI warrants further studies.