Repeated episodes of transient radiating back and leg pain following spinal anesthesia with 1.5% mepivacaine and 2% lidocaine

• Published in: Regional anesthesia and pain medicine Vol. 23; no. 5; pp. 511 - 515
• Main Authors: Liguori, Gregory A., Zayas, Victor M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.09.1998
• Subjects: Aged; Anesthesia, Spinal - adverse effects; Anesthetics, Local - adverse effects; Back Pain - chemically induced; Female; Humans; Infant; Leg; Lidocaine - administration & dosage; local anesthetic toxicity; mepivacaine; Mepivacaine - adverse effects; Pain - chemically induced; spinal anesthesia; spinal stenosis; transient radiating back and leg pain; transient radicular irritation; spinal stenosis; local anesthetic toxicity; transient radiating back and leg pain; spinal anesthesia; mepivacaine; transient radicular irritation
• ISSN: 1098-7339; 1532-8651
• DOI: 10.1016/S1098-7339(98)90037-2

Background and Objectives. Transient radiating back and leg pain defined as pain or dysesthesias in the buttocks, thighs, or calves within 24 to 48 hours after recovery from spinal anesthesia has been described with the use of 2% and 5% lidocaine. These symptoms have also been associated with other local anesthetics such as bupivacaine and tetracaine, although with a much lower incidence. A recent case report and prospective study have described transient radiating back and leg pain occurring following spinal anesthesia with 4% mepivacaine. Methods. We describe a case of transient radiating back and leg pain following spinal anesthesia with 1.5% mepivacaine in a patient with unrecognized spinal stenosis who had had repeated episodes of transient radiating back and leg pain associated with lidocaine spinals. Results. Spinal anesthesia with 1.5% mepivacaine was associated with transient radiating back and leg pain, which was similar in quality and duration to prior episodes following spinal anesthesia with lidocaine. Conclusions. Transient radiating back and leg pain may occur with lower concentrations (1.5%) of mepivacaine, as it does with lidocaine. The relationship between transient radiating back and leg pain and spinal stenosis is also discussed.