Wong C A, Slavenas P
Department of Anesthesiology, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Reg Anesth Pain Med. 1999 Jan-Feb;24(1):55-8. doi: 10.1016/s1098-7339(99)90166-9.
Transient radicular irritation (TRI) has been described after spinal anesthesia, particularly with 5% hyperbaric spinal lidocaine. The purpose of this study was to determine the incidence of TRI in obstetric patients.
All obstetric patients undergoing spinal anesthesia during a 9-month period were enrolled in the study (n = 303). Details of the anesthetic technique were recorded at the time of anesthesia. A blinded anesthesia nurse contacted each patient on postoperative day 2 and asked about symptoms of TRI.
Most patients received either intrathecal hyperbaric bupivacaine 0.75 % (n = 232) or lidocaine 5 % (n = 67) through pencil-point needles. Cerebrospinal fluid was used to dilute the spinal lidocaine in 63% of patients. Patients receiving bupivacaine were more often in the supine position, underwent significantly longer procedures, and more often received intrathecal opioid. The incidence of TRI after lidocaine spinal anesthesia was 0% (95% confidence interval 0-4.5%).
The incidence of TRI after spinal lidocaine anesthesia in the obstetric population is low.
脊髓麻醉后曾有短暂性神经根刺激（TRI）的描述，尤其是使用5%的高压脊髓利多卡因时。本研究的目的是确定产科患者中TRI的发生率。
在9个月期间接受脊髓麻醉的所有产科患者纳入本研究（n = 303）。麻醉时记录麻醉技术的详细情况。一名不知情的麻醉护士在术后第2天联系每位患者，询问TRI的症状。
大多数患者通过笔尖式针接受鞘内注射0.75%的高压布比卡因（n = 232）或5%的利多卡因（n = 67）。63%的患者使用脑脊液稀释脊髓利多卡因。接受布比卡因的患者更常处于仰卧位，手术时间明显更长，且更常接受鞘内阿片类药物。利多卡因脊髓麻醉后TRI的发生率为0%（95%置信区间0 - 4.5%）。
产科人群中利多卡因脊髓麻醉后TRI的发生率较低。
