Waters J H, Watson T B, Ward M G
Department of Anesthesiology, University of California, Irvine, Orange 92668, USA.
J Clin Anesth. 1996 Dec;8(8):656-8. doi: 10.1016/s0952-8180(96)00146-8.
Multiple reports of cauda equina syndrome and transient radicular nerve root irritation have suggested that lidocaine spinal anesthesia may be responsible. In this case report, a patient with a preexisting diabetic neuropathy received a partial block following a tetracaine spinal, which was followed by a lidocaine spinal. Following block resolution, a new conus medullaris syndrome was diagnosed. Because of the close proximity of the cauda equina and the conus medullaris, differentiation between these syndromes can be difficult. The preexisting diabetic neuropathy may have predisposed this patient to neurologic injury. The choice of a different local anesthetic drug with less neurotoxic potential such as bupivacaine may have prevented this injury.
多例马尾综合征和短暂性神经根刺激的报告表明，利多卡因脊髓麻醉可能是病因。在本病例报告中，一名患有糖尿病性神经病变的患者在接受丁卡因脊髓麻醉后出现部分阻滞，随后又接受了利多卡因脊髓麻醉。阻滞消退后，诊断出一种新的圆锥马尾综合征。由于马尾和圆锥位置相近，区分这些综合征可能很困难。该患者先前存在的糖尿病性神经病变可能使其易发生神经损伤。选择神经毒性较小的不同局部麻醉药（如布比卡因）可能会避免这种损伤。
