Subarachnoid Small-Dose Bupivacaine Versus Lidocaine for Cervical Cerclage

Beilin, Yaakov; Zahn, Jeffrey; Abramovitz, Sharon; Bernstein, Howard; Bodian, Carol

doi:10.1213/01.ane.0000068940.36040.54

Cited by 23 publications

(20 citation statements)

References 18 publications

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“…All these RCTs compared lidocaine with other local anesthetics (bupivacaine, prilocaine, mepivacaine, levobupivacaine, chloroprocaine, ropivacaine, procaine, articaine, or sameridine) and reported the incidence of TNS. We found that 28 RCTs had two groups [4][5][6][7][8][9][10][11][12]14,15,18,23,26,27,29,30,[34][35][36][37][38][39][40][41][42]44,46] of lidocaine more than other local anesthetics, while 11 RCTs had multiple groups [13,16,17,24,25,28,[31][32][33]43,45]. Five out of 11 RCTs have more than two lidocaine groups [16,24,28,33,43].…”

Section: Descriptions Of Trialsmentioning

confidence: 99%

“…The relationship between the incidence of TNS and baricity or concentration is shown in Figure 5. Sixteen studies used hyperbaric lidocaine [5,6,11,13,15,16,18,28,[32][33][34][35][36]39,42,45], 12 studies used isobaric [14,17,[23][24][25][26][27][29][30][31]41,44], and 4 studies used hypobaric lidocaine for spinal anesthesia [4,7,26,33]. One study had two treatment groups that administered hyperbaric or isobaric lidocaine [43].…”

Section: Outcome Synthesismentioning

confidence: 99%

See 1 more Smart Citation

Lidocaine vs. Other Local Anesthetics in the Development of Transient Neurologic Symptoms (TNS) Following Spinal Anesthesia: A Meta-Analysis of Randomized Controlled Trials

Koo

Shin

Han

et al. 2020

JCM

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The use of lidocaine in spinal anesthesia may increase the risk of transient neurological symptoms (TNS) according to previous meta-analyses. However, the previous meta-analyses lacked data on some other local anesthetics and thus, more evaluations are still needed to compare the effect of lidocaine on the development of TNS. The objective of this study was to compare the risk of TNS according to lidocaine versus other local anesthetics in patients undergoing spinal anesthesia. A total of 39 randomized controlled trials with 4733 patients were analyzed. The incidence of TNS was 10.8% in the lidocaine group and was 2.2% in the control groups (risk ratio (RR) 4.12, 95% confidence interval (CI) 3.13 to 5.43, p < 0.001). In subgroup analysis, lidocaine increased the incidence of TNS compared with other local anesthetics except mepivacaine, ropivacaine or sameridine. The risk of TNS was higher in the hyperbaric (p < 0.001) or isobaric lidocaine (p < 0.001) group compared with the control group, but there were no differences found between the two groups when hypobaric lidocaine was administered (p = 1.00). This study confirmed that lidocaine for spinal anesthesia still causes TNS more frequently than most other local anesthetics, especially when hyperbaric or isobaric lidocaine was used.are still needed to confirm favorable results for these aforementioned local anesthetics. In the last decade, many randomized controlled trials (RCTs) comparing between the incidence of TNS after lidocaine and other local anesthetics have been conducted. More subsequent studies evaluating the effect of lidocaine on the risk of TNS have been published [2,3]. Furthermore, among them, many studies reported no patients suffering from TNS after spinal anesthesia with lidocaine [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Therefore, it is still controversial on the safety of lidocaine for spinal anesthesia during ambulatory surgery in terms of TNS. The objective of this systematic review and meta-analysis is to compare the incidence of TNS between lidocaine and other local anesthetics and to evaluate the frequency of TNS with various types of local anesthetics in adult surgical patients after spinal anesthesia. read the full text to select studies that were appropriate for this meta-analysis. The inclusion criteria were (1) randomized controlled trials, (2) surgical patients under spinal anesthesia, (3) lidocaine use for spinal anesthesia in at least in one group, and (4) use of other local anesthetic for spinal anesthesia in the control group. The exclusion criteria were: (1) abstract, protocol, conference poster or review; and (2) The study which did not report the incidence of TNS. S.-H.H. participated on selection if any disagreement existed. Data ExtractionC.-H.K. and H.-J.S. independently investigated and collected the following data from final full-texts: author, publication year, language, sample size, type of surgery, type of anesthesia, patient's position during surgery, needle type, characteristics of lidocaine (concentr...

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Section: Descriptions Of Trialsmentioning

confidence: 99%

Section: Outcome Synthesismentioning

confidence: 99%

Lidocaine vs. Other Local Anesthetics in the Development of Transient Neurologic Symptoms (TNS) Following Spinal Anesthesia: A Meta-Analysis of Randomized Controlled Trials

Koo

Shin

Han

et al. 2020

JCM

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“…Possible physiological changes that occur during and remain after pregnancy have been associated with altered outcomes in TNS. 19 , 43 , 44 Phillip et al 19 compared 5.0% hyperbaric lidocaine to 0.75% hyperbaric bupivacaine in twenty-eight women undergoing postpartum tubal ligation. Their findings of 3.0% TNS in the lidocaine and 7.0% in the bupivacaine group suggest an insignificant outcome between the groups.…”

Section: Pregnangy As a Special Co-morbiditymentioning

confidence: 99%

Transient Neurologic Symptoms: Lidocaine Hurting for Attention

2008

IJA

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The aging population is expected to impact ambulatory surgery upward by 53% by the year 2020. In the past, lidocaines popularity in neuraxial anesthetics for short procedures allowed for a quick recovery and discharge. However, the growing number of outpatient procedures combined with rapid discharge criteria has brought attention to lidocaine intrathecal (IT) regional anesthesia and concern over developing Transient Neurologic Symptoms (TNS). A literature search was performed for available research on intrathecal administration of lidocaine with a focal measurement on TNS as a complication. Additionally, comparison of lidocaine to other local anesthetics, etiological factors for developing TNS, and pain association are gathered and reported. The role of TNS on future IT lidocaine use for outpatient procedures is contemplated and special patient populations that may be protected from developing TNS are discussed. Anesthesia providers should base their continued usage of intrathecal lidocaine on evidence based practice.

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“…In recent years efforts have been made to improve the spinal anaesthetic technique for day care surgeries by reducing the dose of local anaesthetics and the addition of small doses of opioids to obtain satisfactory pain relief. [6][7][8][9] This combination utilizes the advantage of synergistic action of local anaesthetics with opiates thereby producing adequate analgesia and lesser intensity of motor blockade leading to early discharge of the patients from the hospital. Therefore, this study was conducted to compare the technique of local infiltration block with spinal anesthesia using 1% lidocaine (isobaric) in combination with 25mcg of fentanyl in patients undergoing day care hydrocele surgery.…”

Section: Introductionmentioning

confidence: 99%

A Randomised Controlled Trial of Infiltration versus Low Dose Subarachnoid Block in Hydrocele Surgery

Siddiqi¹,

Athar²,

Ali³

et al. 2016

AIMDR

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Background: Hydrocele surgery is a short surgical procedure requiring an anaesthetic technique that allows good surgical anaesthesia, short recovery time and minimal side effects. This study was designed to compare the traditionally used technique of local infiltration block and subarachnoid block using 1% lidocaine with 25mcg of fentanyl in patients undergoing hydrocele surgery. Methods: Sixty ASA grade I and II patients of 18-60 years of age, scheduled for hydrocele surgery were randomly assigned to two groups of 30 patients each. Group C patients received local infiltration using 1% lidocaine (maximum upto 5mg /kg) while Group I patients received intrathecal injection of 1% lidocaine with 25 mcg of fentanyl (1.5 ml of 2% lidocaine + 1 ml of normal saline + 0.5 ml fentanyl). The subjects were assessed in terms of physiological variables, the quality of analgesia, and incidence of side effects as compared to local infiltration technique. Results: Patients in group C required significantly more number of fentanyl boluses for pain as compared to patients in group I. The most common problem encountered in any group was backache with an incidence of 16.6% in group I and 6.6% in group C. Pruritus was reported to be 13.3% in group I but was absent in group C (P<0.05). However, it was mild and did not require any medication. 23 patients in group I regarded their experience of the perioperative period as excellent as compared to only 5 patients in group C. Time to void and to meet discharge criteria was comparable in both the groups. Conclusion: We conclude that the use of smaller dose lidocaine-fentanyl combination in spinal anaesthesia provides potent and excellent quality of analgesia with limited side effects without prolonging recovery as compared to 1% lidocaine infiltration in patients of hydrocele surgery.

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Subarachnoid Small-Dose Bupivacaine Versus Lidocaine for Cervical Cerclage

Cited by 23 publications

References 18 publications

Lidocaine vs. Other Local Anesthetics in the Development of Transient Neurologic Symptoms (TNS) Following Spinal Anesthesia: A Meta-Analysis of Randomized Controlled Trials

Lidocaine vs. Other Local Anesthetics in the Development of Transient Neurologic Symptoms (TNS) Following Spinal Anesthesia: A Meta-Analysis of Randomized Controlled Trials

Transient Neurologic Symptoms: Lidocaine Hurting for Attention

A Randomised Controlled Trial of Infiltration versus Low Dose Subarachnoid Block in Hydrocele Surgery

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