Transient neurological symptoms following spinal anesthesia with 0.5% bupivacaine
Journal Title: Medpulse International Journal of Anesthesiology - Year 2017, Vol 2, Issue 2
Abstract
Background: Transient neurological symptoms (TNS) are defined as symmetrical bilateral pain in the back or buttocks or pain radiating to the lower extremities after recovery from spinal anesthesia. Aims and Objectives: To determine the incidence of transient neurological symptoms after spinal anesthesia with 0.5% bupivacaine Materials and Method: Total 30 cases of ASA 1 or 2 admitted in the institute of various surgeries under spinal anesthesia were selected for the study. All patients were premedicated with diazepam 5–15 mg orally. Before the anesthesia was inducted baseline vital parameter were recorded. Intravenous access was established and preloading with normal saline was done. Spinal anesthesia was induced with the patient in the sitting position. 0.5% heavy bupivacaine, 2.2-2.5ml was injected. All the cases were examined post operatively and were followed up after 48 and 72 hours postoperatively. All the patients were observed postoperatively to identify those developed transient neurological symptoms, the location of pain, and onset of pain after recovery of block, duration of pain after recovery of block, management and its outcome. Results: The mean age of the patients was 37.8±3.94 years with mean weight and height 61.4±9.82kg and 162±4.18cm respectively. 27-gauge needle was used in 63.33% patients. In 80% patients the dura was punctured in first attempt. The transient neurological symptoms were diagnosed in 3 (10%) patients. one patient complain buttock pain while one had pain in buttock and thigh and one had pain in thigh only. All the patients had onset of pain within 24 hours of recovery from block. In majority (2 patients) of the patients pain was relived with 12 hours while in the remaining one patient the pain relived in 24 hours after the use of NSAID. Conclusion: The incidence of the transient neurological symptom was 10% in the present study. Transient neurological symptoms developed within 24hours postoperatively and subside within 24 hours of development.
Authors and Affiliations
Abhinay Ramchandra Harankhedkar, Prakash Kisanrao Surwade
Keywords
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