The influence of ambulation time on the incidence of transient neurologic symptoms after lidocaine spinal anesthesia.
The cause of transient neurologic symptoms (TNSs) after lidocaine spinal anesthesia remains unclear. It has been proposed that early ambulation after spinal anesthesia contributes to the development of TNSs. We evaluated the influence of ambulation time on the occurrence of TNSs after spinal anesthesia with 50 mg of 2% plain lidocaine for knee arthroscopy. One-hundred-twenty patients undergoing knee arthroscopy (ASA physical status 1-2) were randomized into 3 groups, i.e., early (Group E), 6-h (Group 6-h), or late ambulation (Group L) groups. In Group E, ambulation was allowed as early as possible after regression of spinal block (on average 229 +/- 21 min; range, 135-247 min). In Group 6-h, the patients remained in bed for approximately 6 h after the block and in Group L until the next morning. The patient groups were comparable with respect to demographic, anesthetic, and surgical variables. The overall incidence of TNSs was 16%. TNSs occurred in 3 patients of Group E (7.5%), in 11 patients of Group 6-h (28%), and in 5 patients of Group L (13%). No significant differences were detected between the patients with and without TNSs. Early ambulation was not found to be a risk factor for TNSs after spinal anesthesia with 50 mg of 2% lidocaine.


CONCLUSIONS
This study shows that early ambulation time does not increase the incidence of transient neurologic symptoms after spinal anesthesia with 50 mg of 2% lidocaine for elective knee arthroscopy.
Research Institute of Military Medicine, Central Military Hospital, Helsinki, Finland.
Martti
M
Silvanto
Pekka
P
Tarkkila
Marja-Leena
ML
Mäkelä
Per H
PH
Rosenberg
D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D001182:Arthroscopy; D004434:Early Ambulation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007717:Knee / Q000601:surgery; D008012:Lidocaine / Q000009:adverse effects*; D008297:Male; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000139:chemically induced* / Q000453:epidemiology*; D012307:Risk Factors; D013997:Time Factors
D000779:Anesthetics, Local; D008012:Lidocaine