Biomaterial Database

Repeated episodes of transient radiating back and leg pain following spinal anesthesia with 1.5% mepivacaine and 2% lidocaine. 1998

G A Liguori, and V M Zayas

Department of Anesthesia, Cornell University Medical Center, New York, New York, USA.

OBJECTIVE 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.

UI	MeSH Term	Description	Entries
D007223	Infant	A child between 1 and 23 months of age.	Infants
D007866	Leg	The inferior part of the lower extremity between the KNEE and the ANKLE.	Legs
D008012	Lidocaine	A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.	Lignocaine,2-(Diethylamino)-N-(2,6-Dimethylphenyl)Acetamide,2-2EtN-2MePhAcN,Dalcaine,Lidocaine Carbonate,Lidocaine Carbonate (2:1),Lidocaine Hydrocarbonate,Lidocaine Hydrochloride,Lidocaine Monoacetate,Lidocaine Monohydrochloride,Lidocaine Monohydrochloride, Monohydrate,Lidocaine Sulfate (1:1),Octocaine,Xylesthesin,Xylocaine,Xylocitin,Xyloneural
D008619	Mepivacaine	A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)	Carbocaine,Carbocaïne,Isocaine,Isogaine,Meaverin,Mecain,Mepihexal,Mepivacain-Injektopas,Mepivacaina Braun,Mepivacaine Hydrochloride,Mepivacaine Monohydrochloride,Mepivastesin,Polocaine,Scandicain,Scandicaine,Scandinibsa,Scandonest,Mepivacain Injektopas
D010146	Pain	An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.	Suffering, Physical,Ache,Pain, Burning,Pain, Crushing,Pain, Migratory,Pain, Radiating,Pain, Splitting,Aches,Burning Pain,Burning Pains,Crushing Pain,Crushing Pains,Migratory Pain,Migratory Pains,Pains, Burning,Pains, Crushing,Pains, Migratory,Pains, Radiating,Pains, Splitting,Physical Suffering,Physical Sufferings,Radiating Pain,Radiating Pains,Splitting Pain,Splitting Pains,Sufferings, Physical
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D000775	Anesthesia, Spinal	Procedure in which an anesthetic is injected directly into the spinal cord.	Anesthesias, Spinal,Spinal Anesthesia,Spinal Anesthesias
D000779	Anesthetics, Local	Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.	Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics