Is transient lumbar pain after spinal anaesthesia with lidocaine influenced by early mobilisation?

Background: The aetiology of transient lumbar pain (TLP) after spinal anaes thesia has generated much interest. Many theories have been discussed. Earl y ambulation has been suggested as one plausible theory for developing TLP. Methods: A total of 107 patients scheduled for inguinal hernial repair unde r spinal anaesthesia (20 mg/ml hyperbaric lidocaine) were randomised to eit her early or late ambulation: the early ambulation (group A), as early as p ossible after total regression of spinal block or the late mobilisation (gr oup B) bedridden for more than 12 h. The clinical course and duration of op eration were monitored. Assessments 4, 8 and 12 h after spinal anaesthesia were performed with respect to wound pain, nausea, tiredness and eventual s ymptoms of TLP were recorded. The patients also kept a diary about any symp toms once daily day 1-3 at home. A telephone follow-up was performed at day 5-7. Results: Our results showed an incidence of TLP of 23% in all patients. No difference was recorded between early and late mobilisation patients, 12 an d 13 patients, respectively. Conclusion: Early ambulation does not seem to increase the risk of developing TLP.