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Commentary: Neurotoxicity of Local Anesthetics—An Issue or a Scapegoat?
  1. Daniel C. Moore, M.D. and
  2. Gale E. Thompson, M.D.
  1. From the Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington.
  1. Reprint requests: Daniel C. Moore, M.D., Department of Anesthesiology, B2-AN, Virginia Mason Medical Center, 1100 Ninth Avenue, P.O. Box 900, Seattle, WA 98111-0900.


Background and Objectives To evaluate the etiologies of cauda equina syndrome (CES) and transient radicular irritation (TRI) or transient neurologic symptoms (TNSs) following hyperbaric spinal anesthesia.

Methods A review of recent (since 1991) and prior (since 1941) investigations regarding CES and TRI (TNSs) was conducted.

Results Recent publications fail to recognize significant prior information regarding CES and TRI (TNSs).

Conclusions Cauda equina syndrome is, in all probability, explainable. Further investigation to pinpoint the etiology of TRI (TNSs) is needed.

  • hyperbaric spinal anesthesia
  • radiating back pain
  • cauda equina syndrome
  • transient radicular irritation
  • transient neurologic symptoms

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