Liguori G A, Zayas V M
Department of Anesthesia, Cornell University Medical Center, New York, New York, USA.
Reg Anesth Pain Med. 1998 Sep-Oct;23(5):511-5. doi: 10.1016/s1098-7339(98)90037-2.
Transient radiating back and leg pain defined as pain or dysesthesias in the buttocks, thighs, or calves within 24 to 48 hours after recovery from spinal anesthesia has been described with the use of 2% and 5% lidocaine. These symptoms have also been associated with other local anesthetics such as bupivacaine and tetracaine, although with a much lower incidence. A recent case report and prospective study have described transient radiating back and leg pain occurring following spinal anesthesia with 4% mepivacaine.
We describe a case of transient radiating back and leg pain following spinal anesthesia with 1.5% mepivacaine in a patient with unrecognized spinal stenosis who had had repeated episodes of transient radiating back and leg pain associated with lidocaine spinals.
Spinal anesthesia with 1.5% mepivacaine was associated with transient radiating back and leg pain, which was similar in quality and duration to prior episodes following spinal anesthesia with lidocaine.
Transient radiating back and leg pain may occur with lower concentrations (1.5%) of mepivacaine, as it does with lidocaine. The relationship between transient radiating back and leg pain and spinal stenosis is also discussed.
短暂性放射至背部及腿部疼痛定义为脊髓麻醉恢复后24至48小时内臀部、大腿或小腿出现的疼痛或感觉异常，使用2%和5%利多卡因时曾有过此类描述。这些症状也与其他局部麻醉药如布比卡因和丁卡因有关，尽管发生率要低得多。最近一份病例报告和前瞻性研究描述了使用4%甲哌卡因进行脊髓麻醉后出现短暂性放射至背部及腿部疼痛的情况。
我们描述了一例使用1.5%甲哌卡因进行脊髓麻醉后出现短暂性放射至背部及腿部疼痛的病例，该患者患有未被识别的椎管狭窄，既往曾多次出现与利多卡因脊髓麻醉相关的短暂性放射至背部及腿部疼痛发作。
使用1.5%甲哌卡因进行脊髓麻醉与短暂性放射至背部及腿部疼痛相关，其性质和持续时间与既往利多卡因脊髓麻醉后的发作相似。
与利多卡因一样，较低浓度（1.5%）的甲哌卡因也可能导致短暂性放射至背部及腿部疼痛。还讨论了短暂性放射至背部及腿部疼痛与椎管狭窄之间的关系。
