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Transient restless legs syndrome after spinal anesthesia

A prospective study

From the Departments of Neurology (Drs. Högl, Frauscher, Seppi, and Poewe) and Biostatistics (Dr. Ulmer), University of Innsbruck, Austria.

Address correspondence and reprint requests to Dr. Werner Poewe, Department of Neurology, University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria; e-mail: werner.poewe{at}uibk.ac.at

Objective: To assess the incidence and time course of new-onset restless legs syndrome (RLS) after spinal anesthesia.

Methods: A total of 202 consecutive patients undergoing spinal anesthesia for various types of surgery were prospectively evaluated regarding the presence and severity of RLS symptoms 48 to 72 hours post surgery and after 1 week, 1 month, 3 months, and 6 months. A diagnosis of RLS was made according to the criteria of the International RLS Study Group (IRLSSG), and severity was assessed by the IRLSSG severity scale.

Results: Of 161 patients without any history of RLS, 8.7% developed first-onset RLS after spinal anesthesia. Symptoms were transient, with a mean duration of 33 ± 30 days. Low mean corpuscular volume and mean corpuscular hemoglobin were associated with the occurrence of new-onset RLS after spinal anesthesia.

Conclusions: Transient RLS can be induced by spinal anesthesia. The mechanisms by which spinal anesthesia can trigger RLS are unclear but may include deficits in spinal sensorimotor integration in susceptible individuals.

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