Transient Neurologic Symptoms Following Spinal Anesthesia with Bupivacaine and Ropivacaine

Abstract

Transient neurologic syndrome (TNS) is a common self-limited complication of spinal anesthesia. Many local anesthetics can cause transient neurological syndrome, in which the incidence of lidocaine is relatively high. In addition, bupivacaine, levobupivacaine, articaine, and ropivacaine can also cause TNS. We conducted a consecutive retrospective cohort study to investigate the incidence of TNS and its associated factors in patients treated with bupivacaine and ropivacaine. We conducted a retrospective cohort study, reviewing the medical records of surgical patients who received bupivacaine and ropivacaine spinal anesthesia in Chengdu Shuangliu District First People's Hospital in the past year to determine the incidence of TNS. For the first time, we used the TNS score table to quantify the occurrence of TNS. There were 24 cases (41.38%) of TNS in the bupivacaine group and 45 cases (33.33%) of TNS in the ropivacaine group. There was no significant difference in VAS and TNS scores between the two groups. It was found that the occurrence of TNS with bupivacaine was correlated with VAS score (Pearson correlation = 0.1813), while the occurrence of TNS with ropivacaine was correlated with sensory blockade (Pearson correlation = − 0.0642). The TNS scale can be used to evaluate the postoperative TNS of patients, and ropivacaine is used for spinal anesthesia with appropriate high anesthesia, which is less likely to lead to postoperative TNS.

The effect of needle type (25 G Sprotte vs. Quincke) in spinal anesthesia on the incidence of transient neurologic syndrome: A randomized clinical trial

“…According to our findings, 30% of the studied patients developed TNS. The incidence rate of TNS reported in the literature varies from 6.4% 10 with mepivacaine, 22% with lidocaine, 11 and 41.38% with bupivacaine 12 and also with ropivacaine this syndrome has been reported 13 . The exact etiologic factors for this syndrome are not apparent.…”

The effect of needle type (25G Sprotte vs Quincke) in spinal anesthesia on the incidence of transient neurologic syndrome

“…According to our ndings, 30% of the studied patients developed TNS. The incidence rate of TNS reported in the literature varies from 6.4% [9] with mepivacaine, 22% with lidocaine [10], and 41.38% with bupivacaine [11] and also with ropivacaine this syndrome has been reported [12]. The exact etiologic factors for this syndrome are not apparent.…”

Comparison of an ephedrine infusion with lidocaine %5 for prevention of hypotension during spinal anesthesia in cesarean section

“…Decreased venous return is associated with decreased attrition and insufficient dilatation of the right atrium, leading to bradycardia through the Bain Bridge reflex. In these patients, bradycardia occurs in the case of sympathetic block at the level of T1-4 (cardioaccelerator fibers) [ 8 ]. On the other hand, with block T1-4, compensatory tachycardia generally does not occur in response to hypotension [ 9 ].…”