Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942004000100015
Brazilian Journal of Anesthesiology
Review Article

Sintomas neurológicos transitórios após raquianestesia

Transient neurological symptoms after spinal anesthesia  

Pedro Paulo Tanaka; Maria Aparecida Almeida Tanaka

Downloads: 4
Views: 1549

Resumo

JUSTIFICATIVA E OBJETIVOS: Os sintomas neurológicos transitórios têm sido descritos em pacientes submetidos à raquianestesia sem outras complicações, após completa recuperação do bloqueio espinhal. Este estudo tem por objetivo apresentar uma revisão sobre o assunto. CONTEÚDO: São apresentados a história, incidência, possíveis etiologias, fatores de risco e tratamento dos sintomas neurológicos transitórios. CONCLUSÕES: A raquianestesia é bastante segura e a incidência destes sintomas é relativamente baixa, não justificando o abandono da técnica anestésica, bem como o uso da lidocaína.

Palavras-chave

ANESTÉSICOS, Local, COMPLICAÇÕES, TÉCNICAS ANESTÉSICAS, Regional

Abstract

BACKGROUND AND OBJECTIVES: Transient neurological symptoms have been described in patients submitted to spinal anesthesia without other complications, after total spinal block recovery. This study aimed at reviewing this subject.
CONTENTS: Transient neurological symptoms history, incidence, possible etiologies, risk factors and treatment are presented.
CONCLUSIONS: Spinal anesthesia is a very safe procedure with a low incidence of these symptoms, not justifying abandoning the technique as well as lidocaine.

Keywords

ANESTHETICS, Local: lidocaine; ANESTHETIC TECHNIQUES; Regional: spinal block; COMPLICATIONS: transient neurologic symptoms

References

Moore DC, Thompson GE. Commentary: neurotoxicity of local anesthetics . An issue or a scapegoat?. Reg Anesth Pain Med. 1998;23:605-610.

Aguilar JL. Transient Neurologic Symptoms Following Spinal Anaesthesia: Choice of Local Anaesthetic. Highlights in Regional Anaesthesia and Pain Therapy. 2002;XI:301-306.

Vale NB. Centenário da raquianestesia cirúrgica. Rev Bras Anestesiol. 1998;48:507-520.

Horlocker TT. Neurologic complications of regional anesthesia. Problems in Anesthesia. 2000;12:199-216.

Pollock JE. Lidocaine Spinal Anesthesia: Extent of the Problem and Clinical Puncture. Highlights in Regional Anaesthesia and Pain Therapy. 2002;XI:290-300.

Fortuna A. Bloqueios anestésicos. Rev Bras Anestesiol. 1963;33:227-262.

Phillips OC, Ebner H, Nelson AT. Neurologic complications following spinal anesthesia with lidocaine: a prospective review of 10,440 cases. Anaesthesiol. 1968;30:284-289.

Schell RM, Brauer FS, Cole DJ. Persistent sacral nerve root deficits after continuous spinal anaesthesia. Can J Anaesth. 1991;38:908-911.

Rigler ML, Drasner K, Krejcie TC. Cauda equine syndrome after continuous spinal anesthesia. Anesth Analg. 1991;72:275-281.

Cunto JJ, Tincani FF, Ismael PC et al. Raquianestesia continua: nossa experiência. Rev Bras Anestesiol. 1989;39:75-80.

Imbelloni LE, Gouveia MA. Avaliação de um novo cateter para raquianestesia contínua. Rev Bras Anestesiol. 1999;49:315-319.

Tanaka PP, Tanaka MA, Soares LF. Síndrome da cauda eqüina após raquianestesia: Relato de caso. Rev Bras Anestesiol. 1998;48(^s23):CBA103.

Schneider M, Ettlin T, Kaufmann M. Transient neurologic toxicity after hyperbaric subarachnoid anesthesia with 5% lidocaine. Anesth Analg. 1993;76:1154-1157.

Mandim BLS, Fonseca NM, Amaral APAO. Irritação radicular transitória: Relato de caso. Rev Bras Anestesiol. 2000;50(^s25):CBA109.

Santos SS, Azevedo VF, Santos SR. Irritação radicular transitória: Relato de caso. Rev Bras Anestesiol. 2001;51(^s26):CBA156.

Avidan A, Gomori M, Davidson E. Nerve root inflammation demonstrated by magnetic resonance imaging in a patient with transient neurologic symptoms after intrathecal injection of lidocaine. Anaesthesiol. 2002;97:257-258.

Palmieri JT, Damião J, Capistrano DS. Irritação neurológica transitória com lidocaína em pacientes submetidas à raquianestesia ou peridural para cesariana. Rev Bras Anestesiol. 1999;49(^s24):CBA113.

Freeedman JM, Li D, Drasner K. Transient neurologic symptoms after spinal anesthesia. Anaesthesiol. 1998;89:633-641.

Lindh A, Andersson AS, Westman L. Is transient lumbar pain after spinal anaesthesia with lidocaine influenced by early mobilization?. Acta Anaesthesiol Scand. 2001;45:290-293.

Ready LB, Plumer MH, Haschke RH. Neurotoxicity of intrathecal local anesthetics in rabbits. Anaesthesiol. 1985;63:364-370.

Takenami T, Yagishita S, Asato F. Intrathecal lidocaine causes posterior root axonal degeneration near entry into the spinal cord in rats. Reg Anesth Pain Med. 2002;27:58-67.

Eisenach J, Yaksh T. Safety numbers: How do we study toxicity of spinal analgesics?. Anaesthesiol. 2002;97:1047-1049.

Pollock JE, Burkhead D, Neal JM. Spinal nerve function in five volunteers experiencing transient neurologic symptoms after lidocaína subarachnoid anesthesia. Anesth Analg. 2000;90:658-665.

Friederich P, Schmitz TP. Lidocaine-induced cell death in a human model of neuronal apoptosis. Eur J Anaesthesiol. 2002;19:564-570.

Martínez-Bourio R, Arzuaga M, Quintana JM. Incidence of transient neurologic symptoms after hyperbaric subarachnoid anesthesia with 5% lidocaine and 5% prilocaine. Anesthesiol. 1998;88:624-628.

Hampl KF, Heinzmann-Wiedmer S, Luginbuehl I. Transient neurologic symptoms after spinal anesthesia. Anesthesiol. 1998;88:629-633.

Kishimoto T, Bollen AW, Drasner K. Comparative spinal neurotoxicity of prilocaine and lidocaína. Anesthesiol. 2002;97:1250-1253.

Morisaki H, Masuda J, Kaneko S. Transient neurologic syndrome in one thousand forty-five patients after 3% lidocaine spinal anesthesia. Anesth Analg. 1998;86:1023-1026.

Auroy Y, Narchi P, Messiah A. Serious complications related to regional anesthesia: results of a prospective survey in France. Anaesthesiol. 1997;87:479-486.

Auroy Y, Benhamou D, Bargue L. Major complications of regional anesthesia in France: The SOS regional anesthesia hotline service. Anaesthesiol. 2002;97:1274-1280.

Beardsley D, Holman S, Gantt R. Transient neurologic deficit after spinal anesthesia: local anesthetic maldistribution with pencil point needles?. Anesth Analg. 1995;81:314-320.

Hampl KF, Schneider MC, Pargger H. A similar incidence of transient neurologic symptoms after spinal anesthesia with 2% and 5% lidocaína. Anesth Analg. 1996;83:1051-1054.

Pollock JE, Liu SS, Neal JM. Dilution of spinal lidocaína does not alter the incidence of transient neurologic symptoms. Anaesthesiol. 1999;90:445-450.

Ganem EM, Castiglia YMM, Vianna PTG. Complicações neurológicas determinadas pela anestesia subaracnóidea. Rev Bras Anestesiol. 2002;52:471-480.

5dd7f8e80e8825401c13f286 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections