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Transient radicular irritation with intrathecal plain lignocaine
D J Henderson1, K A Faccenda, L M Morrison
1Dept. of Anaesthetics, St. John's Hospital at Howden, Livingston, UK.
Acta Anaesthesiologica Scandinavica
|May 23, 1998
Summary
A patient experienced severe leg pain after knee surgery due to transient radicular irritation (TRI), potentially linked to a low dose of spinal lignocaine. Full recovery occurred within 36 hours.
Area of Science:
- Anesthesiology
- Neurology
Background:
- Transient radicular irritation (TRI) is a neurological syndrome of unknown etiology.
- Understanding TRI's causes is crucial for patient safety during spinal anesthesia.
Observation:
- A 50-year-old woman developed severe, bilateral buttock and thigh pain post-knee arthroscopy.
- Pain onset occurred at home, 36 hours after receiving 40 mg subarachnoid lignocaine.
- Neurological examination revealed no deficits.
Findings:
- This case represents the lowest reported dose of isobaric preservative-free lignocaine associated with TRI symptoms.
- The absence of confounding factors suggests lignocaine as a potential causative agent.
- Current TRI etiological theories do not fully encompass this presentation.
Implications:
- This case highlights the need for further research into lignocaine's role in TRI.
- Large-scale epidemiological studies are recommended to elucidate TRI's etiology.
- Findings may inform anesthetic practices and patient management.
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