Abstract
The use of lidocaine for spinal anesthesia was introduced in 1948. Because of its rapid onset and predictable duration of action, lidocaine quickly became the most popular drug available for central neuraxial anesthesia. Concern about the use of lidocaine for continuous spinal anesthesia began in 1991 with published reports of cauda equina syndrome after the use of large doses of lidocaine with spinal microcatheters. Subsequently, the syndrome termed transient neurologic symptoms (TNS) was reported after single-dose spinal lidocaine. This report reviews the history of TNS, including early safety studies, and discusses the current incidence and possible causes of TNS. This article also discusses risk factors for the development of TNS, possible alternatives to the use of spinal lidocaine, and rational approaches to available treatment options. Copyright © 2000 by W.B. Saunders Company
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