A. Hiller et Ph. Rosenberg, TRANSIENT NEUROLOGICAL SYMPTOMS AFTER SPINAL-ANESTHESIA WITH 4-PERCENT MEPIVACAINE AND 0.5-PERCENT BUPIVACAINE, British Journal of Anaesthesia, 79(3), 1997, pp. 301-305
Several studies have reported transient neurological symptoms after sp
inal anaesthesia with 5% lignocaine. In order to evaluate the role of
concentrated solutions of local anaesthetic in the development of tran
sient neurological symptoms, 200 ASA I or II patients undergoing minor
orthopaedic or rectal surgery under spinal anaesthesia were allocated
randomly to receive 4% mepivacaine 80 mg or hyperbaric 0.5% bupivacai
ne 10 mg. All patients were interviewed by an anaesthetist approximate
ly 24 h after spinal anaesthesia, and after 1 week patients were asked
to return a written questionnaire. The incidence of transient neurolo
gical symptoms consisting of pain in the buttocks or pain radiating sy
mmetrically to the lower extremities differed (P<0.001) between patien
ts receiving mepivacaine (30%) and those receiving bupivacaine (3%). H
yperbaric 0.5% be recommended for minor lower abdomen or lower extremi
ties.