Reactions 674 - 25 Oct 1997

★Mepivacaine

First report of transient radicular irritation followingintrathecal administration: 2 case reports

Two women, aged 28 and 51 years, experienced transientradicular irritation (TRI) following intrathecal administration ofmepivacaine 4% prior to cervical dilatation and curettage.

For both women, spinal anaesthesia was performed at theL3-4 interspace with 70mg of 4% mepivacaine in glucose 9.5%,using a 27-gauge Whitacre needle. The patients were placed inthe lithotomy position and the surgical procedures wereuneventful. However, both women developed aching painradiating from the buttocks to the posterior thighs, 3 and 4hours, respectively, postoperatively.

The pain persisted for 12–24 hours; 1 patient was treatedwith diclofenac and the other with paracetamol[acetaminophen].

Author comment: ‘There are many reports in the literatureof TRI occurring with 5% hyperbaric lidocaine, but this is thefirst report of TRI after spinal anesthesia with 4% hyperbaricmepivacaine.’Lynch J, et al. Transient radicular irritation after spinal anesthesia with hyperbaric4% mepivacaine. Anesthesia and Analgesia 85: 872-873, Oct 1997 -Germany 800619305

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Reactions 25 Oct 1997 No. 6740114-9954/10/0674-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved