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British Journal of Anaesthesia, Vol 79, Issue 3 301-305, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Transient neurological symptoms after spinal anaesthesia with 4% mepivacaine and 0.5% bupivacaine

A. Hiller and P. H. Rosenberg
Department of Anaesthesia, Kuusankoski District Hospital, FIN-45750 Sairaalamaki, Finland; Department of Anaesthesiology, Helsinki University Central Hospital, FIN-00290 Helsinki, Finland

Several studies have reported transient neurological symptoms after spinal anaesthesia with 5% lignocaine. In order to evaluate the role of concentrated solutions of local anaesthetic in the development of transient neurological symptoms, 200 ASA I or II patients undergoing minor orthopaedic or rectal surgery under spinal anaesthesia were allocated randomly to receive 4% mepivacaine 80 mg or hyperbaric 0.5% bupivacaine 10 mg. All patients were interviewed by an anaesthetist approximately 24 h after spinal anaesthesia, and after 1 week patients were asked to return a written questionnaire. The incidence of transient neurological symptoms consisting of pain in the buttocks or pain radiating symmetrically to the lower extremities differed (P < 0.001) between patients receiving mepivacaine (30%) and those receiving bupivacaine (3%). Hyperbaric 0.5% bupivacaine can be recommended for minor operations on the lower abdomen or lower extremities.
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