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Transient radicular irritation followed by meningitis after spinal anesthesia

C Mardirosoff1, L Dumont, M Mattys

  • 1Department of Anesthesiology, Brugmann University Hospital, Brussels, Belgium.

Insights

Hyperbaric 5% lidocaine administered intrathecally may cause neurotoxicity and aseptic meningitis. Careful dosing is crucial during spinal anesthesia to prevent adverse neurological events.

Area of Science:

  • Anesthesiology
  • Neuroscience
  • Toxicology

Background:

  • Hyperbaric 5% lidocaine is frequently used for spinal anesthesia.
  • Recent literature suggests potential neurotoxicity associated with its spinal administration.

Observation:

  • A case of probable neurotoxicity following spinal anesthesia with hyperbaric 5% lidocaine is presented.
  • The patient developed aseptic meningitis subsequent to the lidocaine administration.

Findings:

  • The neurotoxic effects observed were likely dose-dependent.
  • Aseptic meningitis is a potential complication of intrathecal hyperbaric lidocaine.

Implications:

  • This case highlights the risks of using high doses of hyperbaric 5% lidocaine for spinal anesthesia.
  • Clinicians should exercise caution and adhere to recommended dosages to mitigate neurotoxicity risks.

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