[A Case of Persistent Dysesthesia after Uneventful Spinal Anesthesia with Bupivacaine].

Abstract

We report a case of persistent dysesthesia lasting over a year in a patient after uneventful spinal anes- thesia with bupivacaine. A 67-year-old woman received spinal anesthesia for transurethral resection of bladder tumor. The surgery was performed in lithotomy position taking 20 min. Dysesthesia was found in her left lower limb postoperatively. Postoperative magnetic resonance imaging (MRI) revealed lumbar spinal canal stenosis at the L4-5 level, but she did not have any neurological deficits preoperatively. In spite of conser- vative treatment, the dysesthesia persisted for a year. We suspect that neurological symptoms were potentially caused by the interaction of local anesthetic toxicity and lumbar spinal canal stenosis. This case emphasizes the importance of thorough consultation on potential neurological complications following spinal anesthesia including the possibility for prolonged sequelae. In addition an early imaging examination during follow up is quite informative in assessing the situation appropriately.