Dr. Muir of Dalhousie University in Canada, mentions the following in her review([i]): "neurologic problems ranging from headache to paralysis" and she includes adhesive arachnoiditis in her list.
SHORT-TERM COMPLICATIONS: ([ii])
- Post dural puncture headache (commonest)
- Total spinal anaesthesia
- Meningitis (infective or chemical)
- Extradural haematoma
- Extradural abscess
- Anterior spinal artery syndrome (paraplegia)
- Intravascular injection
- Cauda equina syndrome(CES)
- Transient radicular irritation(TRI)
- Cranial nerve lesions/Horner's syndrome (v. rare)
Hampl et al([iii]) suggested that transient neurologic symptoms are "common after spinal anesthesia" and may occur in up to "one third of the patients receiving 5% lidocaine."
Dahlgren ([iv]) wrote about Transient Radicular Irritation(TRI) having an incidence of 15-37% in those patients receiving lidocaine, procaine and mepivicaine (but not bupivicaine). He ascribes the symptoms to hemolyzed blood in the subarachnoid space.
[i] Muir HA Department of Anaesthesia, Dalhousie University, Nova Scotia, Canada, " Epidural Misadventures; A review of the risk and complications."
[ii] With reference to: University of Queensland Internet site "Neurological Complications of epidurals"
[iii] Hampl KF, Schneider MC, Pargger H, Gut J, Drewe J, Drasner K Anesth Analg 1996 Nov;83(5):1051-4 A similar incidence of transient neurologic symptoms after spinal anesthesia with 2% and 5% lidocaine.
[iv] Dahlgren N, Acta Anaesthesiol Scand 1998 42(4):389-390 Lidocaine toxicity: a technical knock-out below the waist?
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