A case report of reappearance of spinal anesthesia.
OBJECTIVE
We present a case of reappearance of spinal anesthesia despite the use of plain (isobaric) lidocaine and without an associated cough or Valsalva maneuver.


METHODS
A 66-year-old man had spinal anesthesia for knee arthroscopy. Two hours after the induction of spinal anesthesia and after the patient's motor strength had returned to the lower extremities, his head was elevated to 30 degrees. His legs became weak and he became hypotensive. Within 1 hour, his strength returned and he was discharged uneventfully.


CONCLUSIONS
The reappearance of spinal anesthesia may be secondary to remixing of the cerebrospinal fluid with the pooled local anesthetic or transfer of the local anesthetic from the subdural to the subarachnoid space with movement of the patient.
Deleon
Alexander M
AM
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. alexdeleon74@hotmail.com
Benzon
Honorio T
HT
Eisenman
Theodore S
TS
Doty
Robert A
RA
Newell
Benjamin
B
McLaughlin
Kathleen
K
D000368:Aged; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000134:cerebrospinal fluid; D006801:Humans; D007022:Hypotension / Q000134:cerebrospinal fluid / Q000139:chemically induced*; D008012:Lidocaine; D008297:Male; D018908:Muscle Weakness / Q000134:cerebrospinal fluid / Q000139:chemically induced*; D016896:Treatment Outcome
D000779:Anesthetics, Local; D008012:Lidocaine