Skip to main content

Advertisement

SpringerLink
Log in

Transient Neurologic Symptoms Following Spinal Anesthesia with Bupivacaine and Ropivacaine

  • Medicine
  • Published:
SN Comprehensive Clinical Medicine Aims and scope Submit manuscript

Abstract

Transient neurologic syndrome (TNS) is a common self-limited complication of spinal anesthesia. Many local anesthetics can cause transient neurological syndrome, in which the incidence of lidocaine is relatively high. In addition, bupivacaine, levobupivacaine, articaine, and ropivacaine can also cause TNS. We conducted a consecutive retrospective cohort study to investigate the incidence of TNS and its associated factors in patients treated with bupivacaine and ropivacaine. We conducted a retrospective cohort study, reviewing the medical records of surgical patients who received bupivacaine and ropivacaine spinal anesthesia in Chengdu Shuangliu District First People’s Hospital in the past year to determine the incidence of TNS. For the first time, we used the TNS score table to quantify the occurrence of TNS. There were 24 cases (41.38%) of TNS in the bupivacaine group and 45 cases (33.33%) of TNS in the ropivacaine group. There was no significant difference in VAS and TNS scores between the two groups. It was found that the occurrence of TNS with bupivacaine was correlated with VAS score (Pearson correlation = 0.1813), while the occurrence of TNS with ropivacaine was correlated with sensory blockade (Pearson correlation = − 0.0642). The TNS scale can be used to evaluate the postoperative TNS of patients, and ropivacaine is used for spinal anesthesia with appropriate high anesthesia, which is less likely to lead to postoperative TNS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Harned ME, Dority J, Hatton KW. Transient neurologic syndrome: a benign but confusing clinical problem. Adv Emerg Nurs J. 2011;33(3):232–6.

    Article  PubMed  Google Scholar 

  2. Zaric D, Pace NL. Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics. Cochrane Database Syst Rev. 2009;2:CD003006.

    Google Scholar 

  3. Sankar A, Behboudi M, Abdallah FW, Macfarlane A, Brull R. Transient neurologic symptoms following spinal anesthesia with isobaric mepivacaine: a decade of experience at Toronto Western Hospital. Anesthesiol Res Pract. 2018;2018:1901426.

    PubMed  PubMed Central  Google Scholar 

  4. Etezadi F, Karimi Yarandi K, Ahangary A, Shokri H, Imani F, Safari S, et al. The effect of needle type, duration of surgery and position of the patient on the risk of transient neurologic symptoms. Anesth Pain Med. 2013;2(4):154–8.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Horlocker TT, Wedel DJ. Neurologic complications of spinal and epidural anesthesia. Reg Anesth Pain Med. 2000;25(1):83–98.

    Article  CAS  PubMed  Google Scholar 

  6. Keld DB, Hein L, Dalgaard M, Krogh L, Rodt SA. The incidence of transient neurologic symptoms (TNS) after spinal anaesthesia in patients undergoing surgery in the supine position. Hyperbaric lidocaine 5% versus hyperbaric bupivacaine 0.5%. Acta Anaesthesiol Scand. 2000;44(3):285–90.

    Article  CAS  PubMed  Google Scholar 

  7. Blanie A, Figueiredo S, Lorre G, Benhamou D. Transient neurologic symptoms (TNS) after intrathecal injection of ropivacaine through a dural tap during an attempted epidural for labour pain relief. Anaesth Crit Care Pain Med. 2017;36(5):325–26.

  8. Gautier PE, De Kock M, Van Steenberge A, Poth N, Lahaye-Goffart B, Fanard L, et al. Intrathecal ropivacaine for ambulatory surgery. Anesthesiology. 1999;91(5):1239–45.

    Article  CAS  PubMed  Google Scholar 

  9. Ganapathy S, Sandhu HB, Stockall CA, Hurley D. Transient neurologic symptom (TNS) following intrathecal ropivacaine. Anesthesiology. 2000;93(6):1537–9.

    Article  CAS  PubMed  Google Scholar 

  10. Takenami T, Wang G, Nara Y, Fukushima S, Yagishita S, Hiruma H, et al. Intrathecally administered ropivacaine is less neurotoxic than procaine, bupivacaine, and levobupivacaine in a rat spinal model. Can J Anaesth. 2012;59(5):456–65.

    Article  PubMed  Google Scholar 

  11. Wulf H, Hampl K, Steinfeldt T. Speed spinal anesthesia revisited: new drugs and their clinical effects. Curr Opin Anaesthesiol. 2013;26(5):613–20.

    Article  CAS  PubMed  Google Scholar 

  12. Vaghadia H, Neilson G, Lennox PH. Selective spinal anesthesia for outpatient transurethral prostatectomy (TURP): randomized controlled comparison of chloroprocaine with lidocaine. Acta Anaesthesiol Scand. 2012;56(2):217–23.

    Article  CAS  PubMed  Google Scholar 

  13. Wu CL, Berenholtz SM, Pronovost PJ, Fleisher LA. Systematic review and analysis of postdischarge symptoms after outpatient surgery. Anesthesiology. 2002;96(4):994–1003.

    Article  PubMed  Google Scholar 

  14. Lirk P, Haller I, Colvin HP, Lang L, Tomaselli B, Klimaschewski L, et al. In vitro, inhibition of mitogen-activated protein kinase pathways protects against bupivacaine- and ropivacaine-induced neurotoxicity. Anesth Analg. 2008;106(5):1456–64.

    Article  CAS  PubMed  Google Scholar 

  15. YaDeau JT, Liguori GA, Zayas VM. The incidence of transient neurologic symptoms after spinal anesthesia with mepivacaine. Anesth Analg. 2005;101(3):661–5.

    Article  CAS  PubMed  Google Scholar 

  16. Pollock JE. Transient neurologic symptoms: etiology, risk factors, and management. Reg Anesth Pain Med. 2002;27(6):581–6.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology, The First People’s Hospital of Shuangliu District, Chengdu, 610200, Sichuan, China

    Yue Hu, Yong Ye, Xue Gong & Fei-fei Ran

Authors
  1. Yue Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yong Ye
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xue Gong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fei-fei Ran
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yue Hu.

Ethics declarations

This study was approved by the ethics committee of The First People’s Hospital of Shuangliu District, Chengdu. All study subjects gave informed consent prior to participating in the study.

Conflict of Interest

The authors declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Medicine

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hu, Y., Ye, Y., Gong, X. et al. Transient Neurologic Symptoms Following Spinal Anesthesia with Bupivacaine and Ropivacaine. SN Compr. Clin. Med. 1, 692–697 (2019). https://doi.org/10.1007/s42399-019-00088-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s42399-019-00088-z

Keywords

Search

Navigation