Reactions 724 - 24 Oct 1998

Mepivacaine

Transient radicular irritation following intrathecalanaesthesia: 3 case reports

Two women and 1 man, aged 42–69 years, experiencedtransient radicular irritation after they received 2% isobaricmepivacaine intrathecally prior to surgery in the lithotomyposition.

In each of the patients, a subarachnoid puncture wasperformed at the L3–4 interspace using a Whitacre needle and2% mepivacaine 3ml was injected over 10–15 seconds. Thesurgical procedures proceeded uneventfully in all 3 patients.However, 6–10 hours postoperatively, each patient developedbilateral pain radiating from the lower part of the back to thedorsolateral sides of both thighs and calves.

The 3 patients received analgesic therapy with ketorolac,mefenamic acid and morphine, respectively. They weredischarged from hospital 1–3 days postoperatively andreported no further sequelae.

Author comment: ‘Our cases indicate that TRI [transientradicular irritation] may occur after the use of an isobaricsolution of 2% mepivacaine. Prospective randomized studiesare warranted to evaluate the incidence of this syndrome afteradministration of spinal mepivacaine and the potentialinteraction between local anaesthetics and surgicalpositioning.’Sia S, et al. Transient radicular irritation after spinal anaesthesia with 2% isobaricmepivacaine. British Journal of Anaesthesia 81: 622-624, Oct 1998 -Italy 800712677

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Reactions 24 Oct 1998 No. 7240114-9954/10/0724-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved