Cauda equina syndrome after spinal anaesthesia with hyperbaric 5% lignocaine: a review of six cases of cauda equina syndrome reported to the Swedish Pharmaceutical Insurance 1993-1997.

Abstract

Six cases of cauda equina syndrome with varying severity were reported to the Swedish Pharmaceutical Insurance during the period 1993-1997. All were associated with spinal anaesthesia using hyperbaric 5% lignocaine. Five cases had single-shot spinal anaesthesia and one had a repeat spinal anaesthetic due to inadequate block. The dose of hyperbaric 5% lignocaine administered ranged from 60 to 120 mg. Three of the cases were most likely caused by direct neurotoxicity of hyperbaric 5% lignocaine. In the other 3 cases, direct neurotoxicity was also probable, but unfortunately radiological investigations were not done to definitely exclude a compressive aetiology. All cases sustained permanent neurological deficits. We recommend that hyperbaric lignocaine should be administered in concentrations not greater than 2% and at a total dose preferably not exceeding 60 mg.

• Authors: C C Loo, L Irestedt
• Journal: Acta anaesthesiologica Scandinavica (Acta Anaesthesiol Scand) Vol. 43 Issue 4 Pg. 371-9 (Apr 1999) ISSN: 0001-5172 [Print] England
• PMID: 10225068 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anesthetics, Local
• Lidocaine

Topics

• Adult
• Adverse Drug Reaction Reporting Systems
• Anesthesia, Spinal (adverse effects, instrumentation, methods)
• Anesthetics, Local (administration & dosage, adverse effects)
• Cauda Equina (drug effects)
• Fecal Incontinence (etiology)
• Female
• Follow-Up Studies
• Humans
• Lidocaine (administration & dosage, adverse effects)
• Male
• Middle Aged
• Nerve Compression Syndromes (chemically induced)
• Penile Erection
• Pressure
• Sensation Disorders (etiology)
• Sweden
• Urinary Incontinence (etiology)
• Urination Disorders (etiology)