Epidural anesthesia with ropivacaine causes transient subclinical neuropathy

Abstract

The development of neuropathy in the postoperative period is a rare complication but it may be associated with regional anesthesia. The objective of the prospective observational study was to detect subclinical signs of neuropathy after abdominal surgery. In Group 1 (n = 80), epidural anesthesia with ropivacaine and combined general anesthesia were used. In Group 2 (n = 95), only general combined anesthesia was applied. The assessment was performed in 3 and 7 days after the surgery. Monofilament testing and assessment of temperature sensitivity were used for detection of sensory neuropathy. No neurological disorders leading to the development of paresis, paralysis, or active complaints were found out. Subclinical neuropathy after abdominal surgery was detected in both groups. After regional block with ropivacaine, the incidence of neuropathy on the 3rd day after surgery during monofilament testing was higher (7.5%) versus general anesthesia (2.1%; p = 0.048). The results of monofilament testing were similar to the results of the cold test (Group 1 - 8.75%, Group 2 - 2.1%; p = 0.046). The detected neuropathy was transient, on the 7th day its manifestations regressed, residual signs of subclinical neuropathy persisted in 1 patient only.