The addition of lidocaine to bupivacaine does not shorten the duration of spinal anesthesia: a randomized, double-blinded study of patients undergoing knee arthroscopy.

BACKGROUND: The duration of spinal anesthesia with bupivacaine is often too long for day surgery. A recent study of patients presenting for transurethral surgery suggested that the addition of a small amount of lidocaine to intrathecal hyperbaric bupivacaine could shorten the duration of the sensory and motor blocks. In this prospective, randomized double-blind study we investigated these findings in patients undergoing unilateral knee arthroscopy. METHODS: Fifty patients were randomized to receive 2 mL hyperbaric 0.5% bupivacaine plus either 0.6 mL 1% lidocaine (lidocaine group) or 0.6 mL saline (control group). The sensory and motor blocks were monitored until complete regression and the patient was ready for discharge. The patients were interviewed 2 and 7 days after the operation about any side effects and any signs of transient neurologic syndrome. RESULTS: Data on 45 patients were available for analysis (24 in the lidocaine group). There was no statistically significant difference between the groups regarding time to readiness for surgery, maximum level of sensory block, total duration of sensory, and motor blocks or time to discharge from the postoperative care unit. Two patients in the control group and 1 patient in the study group had symptoms of transient neurologic syndrome for <24 hours after the operation. One patient had voiding difficulties for 3 days. All symptoms resolved spontaneously. No patient had spinal headache or backache. CONCLUSION: We did not confirm, in patients undergoing knee arthroscopy, that the addition of a small dose of lidocaine to intrathecal hyperbaric bupivacaine could shorten the duration of sensory or motor blocks or time to readiness for discharge from the postanesthesia care unit.

[Critical illness polyneuropathy--a neuromuscular complication in the intensive care patients]. / "Critical illness"-polyneuropati--en neuromuskulaer komplikation hos intensivpatienter.

Critical illness polyneuropathy is a serious, but potentially reversible, complication following the treatment of severe infection and respiratory failure in the intensive care unit. A case of prolonged tetraparesis after severe infection and ventilatory support in a middle-aged woman is described.