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Regional anesthesia in patients with pre-existing neurologic disease

McSwain, Julie R.; Doty, J. Wesley; Wilson, Sylvia H.

Current Opinion in Anaesthesiology: October 2014 - Volume 27 - Issue 5 - p 538–543
doi: 10.1097/ACO.0000000000000107
REGIONAL ANESTHESIA: Edited by Jacques E. Chelly

Purpose of review: Regional anesthesia is controversial in patients with pre-existing neurologic disease. This study reviews the published evidence regarding the utilization and outcomes of regional anesthetics in this population.

Recent findings: Although publications are sparse, neuraxial and peripheral regional techniques have been successfully described in patients with spinal cord injury, multiple sclerosis, Guillain–Barre disease, neurofibromatosis, diseases of the neuromuscular junction, and Charcot–Marie Tooth disease without neurologic complications. Ultrasound guidance may aid in reduction in local anesthetic dose, anatomical evaluation and avoidance of needle trauma.

Summary: Regional anesthesia can be safely utilized in patients with pre-existing neurological disease and may have benefits over general anesthesia; however, a conservative approach is warranted. In addition, further publications regarding regional techniques in this population are needed.

Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina, USA

Correspondence to Sylvia H. Wilson, MD, Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, 167 Ashley Avenue, Suite 301, MSC 912, Charleston, South Carolina, USA. Tel: +1 843 792 2322; fax: +1 843 792 2726; e-mail: wilsosh@musc.edu

© 2014 Lippincott Williams & Wilkins, Inc.