When I joined Anaesthesiology department in 1989, we used to give Spinal lidocaine and there used to be no issues or problems. But since transient neurologic syndrome was described in 1993, we stopped using spinal lidocaine. And now, spinal lidocaine has almost disappeared. Well, let me explain what's this Transient Neurologic Syndrome (TNS). It includes pain in the buttocks radiating to dorsolateral aspects of thighs and calves. It usually resolves within a week.
Rarely, it may continue for two weeks. Interestingly, TNS occurs in fifteen percent of the patients after being given Spinal lidocaine. TNS doesn't occur due to dextrose, opioid or epinephrine. It's no relation with the baricity or gender or needle type. Since lidocaine is stopped being used we often use low dose bupivacaine not exceeding 7.5 mg for day care patients and ambulatory patients. Bye bye spinal lidocaine.
