The incidence of transient radicular irritation after spinal anesthesia in obstetric patients

Abstract

Background and Objectives. 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. Methods. 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 post-operative day 2 and asked about symptoms of TRI. Results. 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%). Conclusions. The incidence of TRI after spinal lidocaine anesthesia in the obstetric population is low.