Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Transient neurological symptoms have been reported after hyperbaric lidocaine 5% spinal anaesthetics. We report a patient with neurogenic back and leg pain after uncomplicated bupivacaine and morphine spinal anaesthesia. A healthy 39-yr-old woman received 1.6 ml hyperbaric bupivacaine 0.75% and 250 micrograms morphine intrathecally. Two hours later, the patient experienced discomfort during suturing of the peritoneum and surgery was completed under general anaesthesia. Recovery was uncomplicated until 13 hr after intrathecal injection, when the patient complained of burning pain in her back extending to the front of the abdomen and similar pain in her thighs. Neurological consultation was obtained. Treatment was started with amitriptyline and the symptoms resolved slowly. Complete recovery occurred over three months. Further studies to assess symptoms after spinal anaesthesia are indicated.
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PMID:Temporary back and leg pain after bupivacaine and morphine spinal anaesthesia. 749 63

Transient neurotoxicity of concentrated local anaesthetics has been thought to be the main reason for transient neurological symptoms after spinal anaesthesia. Profound musculoligamental relaxation by high doses of local anaesthetics may contribute to the development of postoperative musculoskeletal pain. In order to evaluate the role of the loss of strength of the supportive structures of the spine in the development of transient neurological symptoms, 60 patients (ASA I-II) undergoing minor orthopaedic, varicose vein or inguinal hernia operations were allocated randomly to receive spinal anaesthesia with hyperbaric lidocaine 50 mg ml-1 (85-100 mg) or balanced general anaesthesia with neuromuscular block. Patients were interviewed 24 h later and after 1 week they returned a written questionnaire. Transient neurological symptoms, consisting of pain in the buttocks or pain radiating symmetrically to the lower extremities, occurred in eight patients (27%) receiving spinal anaesthesia and in one patient (3%) receiving general anaesthesia (P < 0.05). We conclude that a transient neurotoxic effect of hyperbaric lidocaine 50 mg ml-1 is probably the main reason for transient neurological symptoms after spinal anaesthesia but musculoligamental relaxation may contribute to the development of low back or leg pain after both anaesthetic techniques.
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PMID:Transient neurological symptoms after spinal anaesthesia with hyperbaric 5% lidocaine or general anaesthesia. 1047 26