In the past, lidocaine has been a popular choice as a spinal anesthetic due to rapid regression of sensory and motor block.1 However, its use has declined due to concerns about adverse events.2,3 One of these side effects, transient neurologic symptoms (TNS), manifests as light to severe pain originating in the buttocks and radiating to the lower extremities, which may be a sign of neurotoxicity.2 [...] The purpose of this review is to examine the clinical evidence and guidelines regarding optimal administration and safety of short-acting spinal anesthetics. [...] Of these, 12 described an adequate method of randomization,8-14,17-21 while the other two did not describe the randomization method.15,16 Both patients and outcome assessors were blinded in each trial, with the exception of one single- blind trial21 where outcome assessors were aware of the intervention. [...] Summary of findings Comparison of anesthetics One systematic review5 and four RCTs8,16,17,21 compared the use of bupivacaine with other spinal anaesthetics. [...] Lidocaine use was shown in one study13 to result in shorter time to sensory block recovery and discharge compared to ropivacaine but at the cost of higher rates of TNS and injection site pain.
- Pages
- 21
- Published in
- Canada
