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AMBULATORY ANESTHESIA

The Influence of Ambulation Time on the Incidence of Transient Neurologic Symptoms After Lidocaine Spinal Anesthesia

Martti Silvanto, MD^*, Pekka Tarkkila, MD, PhD, Marja-Leena Mäkelä, MD, and Per H. Rosenberg, MD, PhD

*Research Institute of Military Medicine and Department of Anaesthesia, Central Military Hospital, Helsinki; Department of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital

Address correspondence and reprint requests to Pekka Tarkkila, MD, Department of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, PB 220, Helsinki, FIN-00029 HUS, Finland. Address e-mail to pekka.tarkkila{at}hus.fi

The cause of transient neurologic symptoms (TNSs) after lidocaine spinal anesthesia remains unclear. It has been proposed that early ambulation after spinal anesthesia contributes to the development of TNSs. We evaluated the influence of ambulation time on the occurrence of TNSs after spinal anesthesia with 50 mg of 2% plain lidocaine for knee arthroscopy. One-hundred-twenty patients undergoing knee arthroscopy (ASA physical status 1–2) were randomized into 3 groups, i.e., early (Group E), 6-h (Group 6-h), or late ambulation (Group L) groups. In Group E, ambulation was allowed as early as possible after regression of spinal block (on average 229 ± 21 min; range, 135–247 min). In Group 6-h, the patients remained in bed for approximately 6 h after the block and in Group L until the next morning. The patient groups were comparable with respect to demographic, anesthetic, and surgical variables. The overall incidence of TNSs was 16%. TNSs occurred in 3 patients of Group E (7.5%), in 11 patients of Group 6-h (28%), and in 5 patients of Group L (13%). No significant differences were detected between the patients with and without TNSs. Early ambulation was not found to be a risk factor for TNSs after spinal anesthesia with 50 mg of 2% lidocaine.

IMPLICATIONS: This study shows that early ambulation time does not increase the incidence of transient neurologic symptoms after spinal anesthesia with 50 mg of 2% lidocaine for elective knee arthroscopy.

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