Silvanto Martti, Tarkkila Pekka, Mäkelä Marja-Leena, Rosenberg Per H
Research Institute of Military Medicine, Central Military Hospital, Helsinki, Finland.
Anesth Analg. 2004 Mar;98(3):642-6, table of contents. doi: 10.1213/01.ane.0000103268.05457.61.
The cause of transient neurologic symptoms (TNSs) after lidocaine spinal anesthesia remains unclear. It has been proposed that early ambulation after spinal anesthesia contributes to the development of TNSs. We evaluated the influence of ambulation time on the occurrence of TNSs after spinal anesthesia with 50 mg of 2% plain lidocaine for knee arthroscopy. One-hundred-twenty patients undergoing knee arthroscopy (ASA physical status 1-2) were randomized into 3 groups, i.e., early (Group E), 6-h (Group 6-h), or late ambulation (Group L) groups. In Group E, ambulation was allowed as early as possible after regression of spinal block (on average 229 +/- 21 min; range, 135-247 min). In Group 6-h, the patients remained in bed for approximately 6 h after the block and in Group L until the next morning. The patient groups were comparable with respect to demographic, anesthetic, and surgical variables. The overall incidence of TNSs was 16%. TNSs occurred in 3 patients of Group E (7.5%), in 11 patients of Group 6-h (28%), and in 5 patients of Group L (13%). No significant differences were detected between the patients with and without TNSs. Early ambulation was not found to be a risk factor for TNSs after spinal anesthesia with 50 mg of 2% lidocaine.
This study shows that early ambulation time does not increase the incidence of transient neurologic symptoms after spinal anesthesia with 50 mg of 2% lidocaine for elective knee arthroscopy.
利多卡因脊髓麻醉后短暂性神经症状(TNSs)的病因尚不清楚。有人提出脊髓麻醉后早期活动会促使TNSs的发生。我们评估了活动时间对50mg 2%的普通利多卡因用于膝关节镜检查脊髓麻醉后TNSs发生情况的影响。120例接受膝关节镜检查的患者(ASA身体状况1-2级)被随机分为3组,即早期活动组(E组)、6小时活动组(6-h组)或晚期活动组(L组)。E组在脊髓阻滞消退后尽早允许活动(平均229±21分钟;范围135-247分钟)。6-h组患者在阻滞术后卧床约6小时,L组患者卧床至次日早晨。患者组在人口统计学、麻醉和手术变量方面具有可比性。TNSs的总体发生率为16%。E组3例患者(7.5%)出现TNSs,6-h组11例患者(28%)出现TNSs,L组5例患者(13%)出现TNSs。有和没有TNSs的患者之间未检测到显著差异。对于50mg 2%利多卡因脊髓麻醉后,早期活动未被发现是TNSs的危险因素。
本研究表明,对于择期膝关节镜检查,50mg 2%利多卡因脊髓麻醉后,早期活动时间不会增加短暂性神经症状的发生率。