Transient neurological symptoms after spinal anesthesia

Objective & Hypothesis:Objectives: Transient neurological symptoms (TNS) after spinal anesthesia vary from dysesthesia that is hardly noticed to severe pain.

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Key Findings & Data:The aim of this study was to determine the incidence of TNS and provocative risk factors in 591 patients who underwent central block.

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Conclusion & Impact:A greater number of attempts, the lithotomy position, and co-morbidities such as ASHD and DM increase the incidence of TNS.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Objectives: Transient neurological symptoms (TNS) after spinal anesthesia vary from dysesthesia that is hardly noticed to severe pain. The aim of this study was to determine the incidence of TNS and provocative risk factors in 591 patients who underwent central block. Methods: Before the operation, demographic data and features of the operation and the block were recorded. The patients were evaluated at postoperative 24 and 48 hours and day 7 with regard to TNS in the form of pain (headache, lower back and/or limb pain, backache, pain in the puncture region) and sensation disorders (paresthesia, hypoesthesia, hyperesthesia, anesthesia, dysesthesia). Results: The incidence of TNS among the study patients was 35.7%. It was significantly higher in gynecology and urology patients and was higher in female patients in comparison with male patients. The incidence of TNS was greater when blood in the needle/catheter, pain, or paresthesia was seen, but was not associated with LA agents used in the study. Conclusion: A similar TNS incidence was seen in the results of this study as has been reported in the literature. A greater number of attempts, the lithotomy position, and co-morbidities such as ASHD and DM increase the incidence of TNS.

Özet

Amaç: Santral blok sonrası gözlenen GNS, hastaların zorlukla farkına varabildikleri dizesteziden, çok şiddetli ağrıya kadar oldukça değişken ve geniş şikayetler dizisini içermektedir. GNS sıklığını ve potansiyelize eden risk faktörlerinin belirlenmesini amaçlayan bu çalışmaya, santral blok uygulanan 591 hasta dahil edildi. Gereç ve Yöntem: Operasyon öncesi hastaların demografik bilgileri, operasyon ve uygulanan blok türüne ait özellikler kaydedildi. Hastalar postoperatif 24, 48 saat ve 7. günde GNS olarak ağrı (başağrısı, bel ve/veya bacak ağrısı, sırt ağrısı, girişim yeri ağrısı) ve duyu kusurları (parestezi, hipoestezi, hiperestezi, anestezi, dizestezi) açısından değerlendirildi. Bulgular: Çalışmaya katılan hastalarda GNS sıklığı, %35.7 olarak hesaplanırken, bu oran KHD, üroloji hastalarında anlamlı olarak yüksekti. GNS, kadın hastalarda erkek hastalara göre anlamlı olarak fazla bulundu. Santral blok uygulamaları sırasında iğne/ kateterden kan gelmesi, ağrı ve parestezi varlığında, GNS insidansında artma izlenirken, kullanılan LA ajanlar arasında, GNS insidansında farklılık bulunmadı. Sonuç: Çalışmamızda literatür bilgileriyle benzer GNS oranları bulduk. Artan ponksiyon sayısı, litotomi pozisyonu, eşlik eden ASKH ve DM gibi komorbid durumlar GNS insidansını artırmaktadır.

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Cite This Article

ÇETİN, Z. A., KAYACAN, N., KARSLI, B. (2018). Transient neurological symptoms after spinal anesthesia. Ağrı, Cilt: 30 - Sayı: 2, 58–70. https://ajindex.com/articles/148333

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References (12)

Zaric D, Pace NL. Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics. Cochrane Database Syst Rev 2009:CD003006. Pollock JE, Burkhead D, Neal JM, Liu SS, Friedman A, Stephenson C, et al. Spinal nerve function in five volunteers experiencing transient neurologic symptoms after lidocaine subarachnoid anesthesia. Anesth Analg 2000;90(3):658–65.
Salmela L, Aromaa U, Cozanitis DA. Leg and back pain after spinal anaesthesia involving hyperbaric 5% lignocaine. Anaesthesia 1996;51(4):391–3.
İnanoğlu K, Çağla Özbakış Akkurt B, Yetim Ç. A transient prolonged paresthesia folloeing spinal anesthesia with hiberbaric bupivacaine during caeserean section, Türk Anest Rean Der Dergisi 2006; 34(6):401–404.
Selander D, Dhunér KG, Lundborg G. Peripheral nerve injury due to injection needles used for regional anesthesia An experimental study of the acute effects of needle point trauma. Acta Anaesthesiol Scand 1977;21(3):182–8. Aldrete JA. Neurologic deficits and arachnoiditis following neuroaxial anesthesia. Acta Anaesthesiol Scand 2003;47(1):3–12.
Russell R, Groves P, Taub N, O’Dowd J, Reynolds F. Assessing long term backache after childbirth. BMJ 1993;306(6888):1299–303.
MacArthur C, Lewis M, Knox EG, Crawford JS. Epidural anaesthesia and long term backache after childbirth. BMJ 1990;301(6742):9–12.
Flaatten H, Raeder J. Spinal anaesthesia for outpatient surgery. Anaesthesia 1985;40(11):1108–11.Brattebø G, Wisborg T, Rodt SA, Røste I. Is the pencil point spinal needle a better choice in younger patients? A comparison of 24G Sprotte with 27G Quincke needles in an unselected group of general surgical patients below 46 years of age. Acta Anaesthesiol Scand 1995;39(4):535–8.
Phillips OC, Ebner H, Nelson AT, Black MH. Neurologic complications following spinal anesthesia with lidocaine: a prospective review of 10,440 cases. Anesthesiology 1969;30(3):284–9.
Edomwonyi NP, Isesele TO. Transient neurological symptoms following spinal anesthesia for cesarean section. Middle East J Anaesthesiol 2010;20(6):809–13.
Geurts JW, Haanschoten MC, van Wijk RM, Kraak H, Besse TC. Post-dural puncture headache in young patients. A comparative study between the use of 0.52 mm (25-gauge) and 0.33 mm (29-gauge) spinal needles. Acta Anaesthesiol Scand 1990;34(5):350–3.
Frenkel C, Altscher T, Groben V, Hörnchen U. The incidence of post spinal headache in a group of young patients. Anaesthesist 1992;41(3):142–5.
Lim M, Cross GD, Sold M. Postspi