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Background:
The incidence of transient neurologic symptoms (TNS) after spinal anesthesia with lidocaine is reported as high as 40%.
Anesthesiology and Pain Medicine
The Effect of Needle Type, Duration of Surgery and Position of the Patient on the Risk of Transient Neurologic Symptoms
Author(s):
Farhad Etezadi
1, 
Kourosh Karimi Yarandi2, Aylar Ahangary1, Hajar Shokri1, Farsad Imani1, Saeid Safari3, Mohammad Reza Khajavi1,*1Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, [email protected], Iran
2Department of Neurosurgery, Tehran University of Medical Sciences, Iran
3Department of Anesthesiology, Rasoul Akram Medical Center, Iran University of Medical Sciences (IUMS), Iran
Published online:Mar 26, 2013
Article type:Research Article
Received:Jun 22, 2012
Accepted:Oct 09, 2012
How to Cite:Farhad EtezadiKourosh Karimi YarandiAylar AhangaryHajar ShokriFarsad ImaniSaeid SafariMohammad Reza Khajaviet al.The Effect of Needle Type, Duration of Surgery and Position of the Patient on the Risk of Transient Neurologic Symptoms.Anesth Pain Med.2013;2(4):154-8.https://doi.org/10.5812/aapm.6916.
Abstract
Objectives:
This prospective clinical trial was designed to determine the incidence of TNS in patients who underwent spinal anesthesia with two different needles, in two different surgical positions.
Patients and Methods:
The present randomized clinical trial was conducted on 250 patients (ASA I-II), who were candidates for surgery in supine or lithotomy positions. According to the needle type (Sprotte or Quincke) and local anesthetics (lidocaine and bupivacaine) all patients were randomly divided into four groups. After performing spinal anesthesia in sitting position, the position was changed into supine or lithotomy, according to surgical procedure. The patients were observed for complications of spinal anesthesia during the first five post-operative days. The primary end-point for this trial was to recognize the incidence of TNS among the four groups. Our secondary objective was to evaluate the effect of patient\'s position, needle type, and duration of surgery on the development of TNS following spinal anesthesia.
Results:
TNS was most commonly observed when lidocaine was used as anesthetic drug (P = 0.003). The impact of needle type, was not significant (P = 0.7). According to multivariate analysis, the duration of surgery was significantly lower in cases suffering from TNS (P = 0.04). Also, the risk of TNS increased following surgeries performed in lithotomy position (P = 0.00).
Conclusions:
According to the results of this clinical study, spinal anesthesia with lidocaine, and the lithotomy position in surgery increased the risk of TNS.
Copyright
© 2013, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.
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