مقايسه ليدوكايين (دوز پايين ) - فنتانيل با ليدوكايين بر علايم نورولوژيك گذرا بعد از بيحسي نخاعي

Comparison of Low Dose Lidocaine- Fentanyl and Conventional - dose Lidocaine on Transient Neurologic Symptoms after Spinal Anesthesia

The Syndrome of Transient Neurologic Symptoms (TNS) after spinal Lidocaine injection has been presumed to be a manifestation of local anesthetic neurotoxicity. The purpose of this study was determining the effect of lower doses of intrathecal Lidocaine compared with conventional dose of Lidocaine on the incidence of TNS. 110 patients in ASA classes I-Il presenting for cesarean section were randomly assigned to receive spinal anesthesia with either hyperbaric Lidocaine 50 mg-25 µg Fentanyl or hyperbaric Lidocaine 75 mg. Patients were evaluated for hemodynamic status, peak block level and regression, and Transient Neurologic Symptoms. Both groups had a median peak block level of T4. The control group had a greater need for Ephedrine (P<0.05). Ketamin requirement was similar in both groups (P>0.05) . Block regression was faster in case group (P<0.05). TNS incidence was 29.1% in control group and 5.4% in case group (P<0.05). PDH incidence was similar in both groups (P>0.05). Spinal anesthesia with 50mg Lidocaine and 2514 Fentanyl provides adequate anesthesia with more hemodynamic stability, faster recovery and lesser incidence of TNS syndrome than spinal anesthesia with 75 mg Lidocaine.