Objective: We present a case of reappearance of spinal anesthesia despite the use of plain (isobaric) lidocaine and without an associated cough or Valsalva maneuver.
Case report: A 66-year-old man had spinal anesthesia for knee arthroscopy. Two hours after the induction of spinal anesthesia and after the patient's motor strength had returned to the lower extremities, his head was elevated to 30 degrees. His legs became weak and he became hypotensive. Within 1 hour, his strength returned and he was discharged uneventfully.
Conclusions: The reappearance of spinal anesthesia may be secondary to remixing of the cerebrospinal fluid with the pooled local anesthetic or transfer of the local anesthetic from the subdural to the subarachnoid space with movement of the patient.