Abstract
Occurence of transient neurologic symptoms (TNS) after spinal anesthesia has been reported with several local anesthetics such as lidocaine, prilocaine, mepivacaine, tetracaine, and bupivacaine. Although hyperbaric bupivacaine is known to cause TNS less frequently (0-3% incidence) than lidocaine (10-40%), there is scarcely any report of TNS with isobaric 0.5% bupivacaine. We reported a case of TNS after spinal anesthesia with isobaric 0.5% bupivacaine.
A 40-year-old, obese woman (156cm, 80kg) underwent cervical conization under spinal anesthesia. A 23G Quincke needle was placed into the sub-arachnoidal space through the L45 interspace at the depth of 7cm, followed by injection of 3.6ml of 0.5% isobaric bupivacaine with no paresthesia. The anesthesia was adequately obtained below the level of T6 bilaterally. She was placed in the lithotomy position during surgery for 25 minutes.
On the first postoperative day she complained of dysesthesia in her legs. Neurological examination revealed sensory deficit restricted within bilateral L5 dermatome with no motor weakness. The dysesthesia and sensory loss subsided without any treatment or no sequelae within a week.
We report a case of TNS that lasted a week following spinal anesthesia with 3.6ml of 0.5% isobaric bupivacaine.
