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Transient neurologic toxicity after spinal anesthesia, or is it myofascial pain? Two case reports.

THERE have been several publications of transient neurologic toxicity or transient radicular irritation attributed to intrathecal local anesthetics. Most described cases involved the use of hyperbaric lidocaine, 2 - 5%. Sumi et al. recently reported a case in which tetracaine, 0.5%, was used. Reported cases present with low back or buttock pain radiating to the thighs or lower legs. The pain is usually moderate to severe, appearing 1-24 h postoperatively after recovery from an otherwise uneventful spinal anesthetic. In all reported cases, the symptoms disappeared within 1 week. We report two cases of similar symptoms and circumstances that have the appearance of simple musculoskeletal pain.