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Regional Anesthesia in Patients With Preexisting Neurologic Disease
  1. Sandra L. Kopp, MD,
  2. Adam K. Jacob, MD and
  3. James R. Hebl, MD
  1. From the Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN
  1. Address correspondence to: James R. Hebl, MD, Department of Anesthesiology, Mayo Clinic, 200 First St, SW, Rochester, MN 55905 (e-mail: hebl.james{at}mayo.edu).

Abstract

What’s New Since publication of initial recommendations in 2008, there is limited new information regarding the performance of regional anesthesia in patients with preexisting neurologic diseases. However, the strength of evidence has increased since 2008 regarding (1) the concern that diabetic nerves are more sensitive to local anesthetics and perhaps more susceptible to injury and (2) the concern that performing neuraxial anesthesia and analgesia in patients with preexisting spinal canal pathology may increase the risk of new or worsening neurologic symptoms. This increased evidence reinforces our initial recommendations. In addition, since the initial recommendations in 2008, the concept of postsurgical inflammatory neuropathy has been described and is potentially a contributor to postoperative neurologic dysfunction.

https://doi.org/10.1097/AAP.0000000000000179

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    Footnotes

    • Attribution: Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.

      Financial Sources: None.

      This work was presented in part at the American Society of Regional Anesthesia and Pain Medicine 37th Annual Spring Meeting, San Diego, CA (March 15–18, 2012).

      The authors declare no conflict of interest.