Transient Neurologic Symptoms After Spinal Anesthesia with Lidocaine in Obstetric Patients

We investigated the relationship between intrathecal lidocaine and transient neurologic symptoms in the obstetric population because lidocaine spinal anesthetics are commonly used for various obstetric procedures, and little has been reported in this regard from within this population. In this study, 58 ASA physical status I patients presenting for postpartum bilateral tubal ligation under spinal anesthesia were randomized to receive either hyperbaric 5% lidocaine or 0.75% bupivacaine in a double-blinded manner. All patients were in the supine position for their surgery. Postoperatively, all patients were followed by a blinded investigator using a standardized symptom checklist. The incidence of transient neurologic symptoms with lidocaine was 3% (95% confidence interval = 0.1%–17.8%) and that with bupivacaine was 7% (95% confidence interval = 0.9%–23.5%), (P = not significant). Symptoms consistent with this syndrome occurred within 24 h without any associated sensory or motor deficits or functional impairment, and resolved within 48 h without any intervention. Implications The occurrence of transient neurologic symptoms with intrathecal lidocaine among obstetric patients in the supine surgical position appears to be infrequent and without serious sequelae. However, larger randomized studies conducted under similar controlled conditions are warranted to conclusively ascertain the incidence of transient neurologic symptoms with lidocaine in a similar population.