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Current Opinion in Anaesthesiology:
doi: 10.1097/ACO.0000000000000107
REGIONAL ANESTHESIA: Edited by Jacques E. Chelly

Regional anesthesia in patients with pre-existing neurologic disease

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

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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.

© 2014 Lippincott Williams & Wilkins, Inc.


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