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首页> 外文期刊>Current opinion in anaesthesiology >Transient neurological syndrome: does it really exist?
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Transient neurological syndrome: does it really exist?

机译：短暂性神经系统综合症：真的存在吗？

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摘要

Subarachnoid injection of local anesthetics has been related to the appearance of transient neurological symptoms (called transient neurologic syndrome), as reflected by a number of clinical reports showing their incidence in clinical practice. However, the etiology of this syndrome is virtually unknown, as is the number of factors implicated in its development. This review will attempt to clarify this entity and its relationship with spinal anesthesia.Intrathecal administration of local anesthetics is known to increase glutamate concentration in cerebrospinal fluid and histopathologic changes of motor neurons in the lumbar spinal cord, suggesting damage of dorsal and ventral roots. In-vitro studies of cultured neurons exposed to different concentrations of local anesthetics have shown changes in growth of cones and neurites, which may be related to transient neurologic syndrome.The latest studies show biochemical and anatomopathologic changes that support the structural basis of the existence of transient neurologic syndrome. In the authors' view, transient neurologic syndrome could represent the lower end of a spectrum of local anesthetic toxicity. Recent findings demonstrate that nerve membrane damage induced by highly concentrated local anesthetics such as lidocaine, tetracaine, dibucaine and procaine may generate irreversible neural injury. Still further studies are needed to establish the relationship between morphological changes induced in vitro and the occurrence of clinical symptoms.
机译：蛛网膜下腔注射局部麻醉剂已与短暂性神经症状（称为短暂性神经综合征）的出现有关，许多临床报告均表明其在临床上的发生率。然而，该综合征的病因实际上不明，涉及其发展的因素也很多。这篇综述将试图阐明这种情况及其与脊柱麻醉的关系。鞘内注射局部麻醉剂会增加脑脊液中谷氨酸的浓度以及腰脊髓运动神经元的组织病理学变化，提示背侧和腹侧根部受损。体外研究了暴露于不同浓度局麻药的培养神经元的视锥和神经突生长变化，这可能与短暂性神经系统综合症有关。最新研究表明，生化和解剖病理学变化可支持存在的神经化学结构基础。短暂性神经系统综合症。在作者看来，短暂性神经系统综合症可能代表了局部麻醉药毒性的低端。最近的发现表明，高度集中的局部麻醉药（如利多卡因，丁卡因，地布卡因和普鲁卡因）引起的神经膜损伤可能产生不可逆的神经损伤。建立体外诱导的形态变化与临床症状发生之间的关系还需要进一步的研究。

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