Talakoub Reihanak, Golparvar Mohammad, Arshi Rezvan
Department of Anesthesiology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Critical Care Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2015 Apr;20(4):383-6.
Transient neurological symptoms (TNS), was described in patients recovering from spinal anesthesia with lidocaine but its etiology remains unknown this study was evaluated the influence of ambulation time on the occurrence of TNSs after spinal anesthesia with lidocaine 5%.
This randomized clinical trial was conducted on 60 patients with American Society of Anesthesiologists Grades I and II, who were candidates for lower abdominal surgery in supine or lithotomy positions. Patients were randomly divided into early ambulation group (Group A) who were asked to start walking as soon as the anesthesia was diminished or to the late ambulation group (Group B) who walked after at least 12 h bedridden. Participants were contacted 2 days after spinal anesthesia to assess any type of pain at surgical or anesthesia injection site, muscle weakness, fatigue, vertigo, nausea, vomiting, headache, and difficult urination or defecation.
Four subjects (13.3%) in Group A and two patients (6.7%) in Group B had pain at anesthesia injection site (P = 0.019). Fourteen patients in Group A (46.7%) and six patients in Group B (20%) had post-dural puncture headache (P = 0.014). Participants in Group B reported difficult urination more than Group A (P = 0.002). there were not statistically significant differences between two groups regarding frequency of fatigue, muscle weakness, vertigo, nausea, vomiting, difficult defecation, paresthesia, and the mean of visual analogue scale at the surgical site.
Early ambulation after spinal anesthesia with lidocaine did not increase the risk of neurologic complication.
短暂性神经症状（TNS）在接受利多卡因脊髓麻醉后恢复的患者中有所描述，但其病因尚不清楚。本研究评估了活动时间对5%利多卡因脊髓麻醉后TNS发生的影响。
本随机临床试验对60例美国麻醉医师协会分级为I级和II级、拟行仰卧位或截石位下腹部手术的患者进行。患者被随机分为早期活动组（A组），要求在麻醉消退后尽快开始行走；或晚期活动组（B组），至少卧床12小时后行走。脊髓麻醉2天后联系参与者，评估手术或麻醉注射部位的任何类型疼痛、肌肉无力、疲劳、眩晕、恶心、呕吐、头痛以及排尿或排便困难。
A组有4名受试者（13.3%）和B组有2名患者（6.7%）在麻醉注射部位疼痛（P = 0.019）。A组有14名患者（46.7%）和B组有6名患者（20%）发生了腰穿后头痛（P = 0.014）。B组参与者报告排尿困难的情况多于A组（P = 0.002）。两组在疲劳、肌肉无力、眩晕、恶心、呕吐、排便困难、感觉异常的发生率以及手术部位视觉模拟评分的平均值方面无统计学显著差异。
利多卡因脊髓麻醉后早期活动不会增加神经并发症的风险。
