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Regional Anesthesia in the Presence of Neurologic Disease

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Complications of Regional Anesthesia

Abstract

Performing regional anesthesia in patients with preexisting neurologic or neuromuscular disease remains controversial. Numerous anecdotal reports describe the successful use of regional techniques in a variety of neuromuscular disorders including multiple sclerosis, amyotrophic lateral sclerosis (ALS), muscular dystrophies, myotonias, and others.1 However, a study of significant size to confirm or support the safety of regional anesthesia in these patients continues to remain scarce. Specific guidelines regarding the use of regional techniques in the setting of neurologic disease are difficult to define because of these limitations. Therefore, the goal of this chapter is to review several of the more common neurologic disorders that an anesthesiologist may encounter and outline what information currently exists to help guide the use of regional anesthesia.

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References

  1. Johnson ME. Potential neurotoxicity of spinal anesthesia with lidocaine. Mayo Clin Proc 2000;75(9):921–932.

    Article  PubMed  CAS  Google Scholar 

  2. Ferguson IT, Murphy R, Lascelles R. Ventilatory failure in myasthenia gravis. J Neurol Neurosurg Psych 1982;45:217–222.

    Article  CAS  Google Scholar 

  3. Loh L. Neurological and neuromuscular disease. Br J Anaesth 1986;58:190–200.

    Article  PubMed  CAS  Google Scholar 

  4. Klingler W, Lehmann-Horn F, Jurkat-Rott K. Complications of anaesthesia in neuromuscular disease. Neuromuscul Disord 2005;15:195–206.

    Article  PubMed  Google Scholar 

  5. Stoelting RK, Dierdorf SF. Endocrine disease. In: Anesthesia and Coexisting Disease. 3rd ed. New York: Churchill Livingstone; 1993:342.

    Google Scholar 

  6. Borel C. Evaluation of the patient with neuromuscular disease. In: Rogers MC, Tinker JH, Covino BG, Longnecker DE, eds. Principles and Practice of Anesthesiology. St. Louis: Mosby; 1993:266–275.

    Google Scholar 

  7. Persson A, Solders G. R-R variations in Guillain-Barré syndrome: a test of autonomic dysfunction. Acta Neurol Scand 1983;67:294–300.

    Article  PubMed  CAS  Google Scholar 

  8. Kahn JK, Sisson JC, Vinik AI. Prediction of sudden cardiac death in diabetic autonomic neuropathy. J Nucl Med 1988;29:1605–1606.

    PubMed  CAS  Google Scholar 

  9. Watkins PJ. Diabetic autonomic neuropathy. N Engl J Med 1990;322:1078.

    Article  PubMed  CAS  Google Scholar 

  10. Ellison GW, Visscher BR, Graves MC, et al. Multiple sclerosis. Ann Intern Med 1984; 101:514–526.

    PubMed  CAS  Google Scholar 

  11. Compston DAS. The management of multiple sclerosis. Q J Med 1989;70:93–101.

    PubMed  CAS  Google Scholar 

  12. Tselis A, Lisak RP. Multiple sclerosis: therapeutic update. Arch Neurol 1999;56(3): 277–280.

    Article  PubMed  CAS  Google Scholar 

  13. Perlas A, Chan VWS. Neuraxial anesthesia and multiple sclerosis. Can J Anaesth 2005;52: 457–458.

    Google Scholar 

  14. Sakurai M, Kanagawa I. Positive symptoms in multiple sclerosis: their treatment with sodium channel blockers, lidocaine and mexiletine. J Neurol Sei 1999;162: 162–168.

    Article  CAS  Google Scholar 

  15. McDonald WI, Silberberg DH. Multiple Sclerosis. London: Butterworth; 1986.

    Google Scholar 

  16. Abramsky C. Pregnancy and multiple sclerosis. Ann Neurol 1994;36:S38–41.

    Article  Google Scholar 

  17. Van Walderveen MAA, Tas MW, Barkhof F, et al. Magnetic resonance evaluation of disease existing during pregnancy in multiple sclerosis. Neurology 1994;44:327–329.

    PubMed  Google Scholar 

  18. Damek DM, Shuster EA. Pregnancy and multiple sclerosis. Mayo Clin Proc 1997;72(10): 977–989.

    Article  PubMed  CAS  Google Scholar 

  19. Bamford C, Sibley W, Laguna J. Anesthesia in multiple sclerosis. Can J Neurol Sei 1978;5: 41–44.

    CAS  Google Scholar 

  20. Bader AM, Hunt CO, Datta S, et al. Anesthesia for the obstetric patient with multiple sclerosis. J Clin Anesth 1988;l(l):21–24.

    Article  Google Scholar 

  21. Crawford JS, James FM III, Nolte H, et al. Regional anesthesia for patients with chronic neurological disease and similar conditions. Anaesthesia 1981;36:821.

    Article  Google Scholar 

  22. Stoelting RK, Dierdorf SF. Diseases of the nervous system. In: Anesthesia and Coexisting Disease. 3rd ed. New York: Churchill Livingstone; 1993:217.

    Google Scholar 

  23. Schapira K. Is lumbar puncture harmful in multiple sclerosis? J Neurol Neurosurg Psych 1959;22:238.

    Article  CAS  Google Scholar 

  24. Warren TM, Datta S, Ostheimer GW. Lumbar epidural anesthesia in a patient with multiple sclerosis. Anesth Analg 1982;61:1022–1023.

    Article  PubMed  CAS  Google Scholar 

  25. Varner PD. Anesthesia for the patient with neurologic disease. 46th Annual ASA Refresher Course Lectures 146,1995.

    Google Scholar 

  26. Capdeville M, Hoyt MR. Anesthesia and analgesia in the obstetric population with multiple sclerosis: a retrospective review. Anesthesiology 1994;81(3A):1173.

    Google Scholar 

  27. Confavreux C, Hutchinson M, Hours MM, et al. Rate of pregnancy related relapse in multiple sclerosis. N Engl J Med 1998;339:285–291.

    Article  PubMed  CAS  Google Scholar 

  28. Kytta J, Rosenberg PH. Anesthesia for patients with multiple sclerosis. Ann Chir Gynaecol 1984;73:229–303.

    Google Scholar 

  29. Campbell MJ. Motor neuron diseases. In: Walton J, ed. Disorders of Voluntary Muscle. London: Churchill-Livingstone; 1988:759–792.

    Google Scholar 

  30. Stoelting RK, Dierdorf SF. Diseases of the nervous system. In: Anesthesia and Coexisting Disease. 3rd ed. New York: Churchill-Livingstone; 1993:209.

    Google Scholar 

  31. Kochi T, Oka T, Mizuguchi T. Epidural anesthesia for patients with amyotrophic lateral sclerosis. Anesth Analg 1989;68:410–412.

    Article  PubMed  CAS  Google Scholar 

  32. Warren T, Fletcher M. Anesthetic management of the obstetric patient with neurologic disease. Clin Anaesth 1986;4(2):291–304.

    Google Scholar 

  33. Stoelting RK, Dierdorf SF. Diseases of the nervous system. In: Anesthesia and Coexisting Disease. 3rd ed. New York: Churchill-Livingstone; 1993:226.

    Google Scholar 

  34. Broecker BH, Hranowsky N, Hackler RH. Low spinal anesthesia for the prevention of autonomic dysreflexia in the spinal cord injury patient. J Urol 1979;22:366.

    Google Scholar 

  35. Lambert DH, Deane RS, Mazuzan JE. Anesthesia and the control of blood pressure in patients with spinal cord injury. Anesth Analg 1982;61:344–348.

    Article  PubMed  CAS  Google Scholar 

  36. Ravindan RS, Cummins DF, Smith IE. Experience with the use of nitroprusside and subsequent epidural analgesia in a pregnant quadriplegic patient. Anesth Analg 1981;60: 61–63.

    Google Scholar 

  37. Baraka A. Epidural meperidine for control of autonomic hyperreflexia in a paraplegic parturient. Anesthesiology 1985;62:688–690.

    Article  PubMed  CAS  Google Scholar 

  38. Stoelting RK, Dierdorf SF. Diseases of the nervous system. In: Anesthesia and Coexisting Disease. 3rd ed. New York: Churchill-Livingstone; 1993:218.

    Google Scholar 

  39. Burgos LG, Ebert TJ, Asiddao C, et al. Increased intraoperative cardiovascular morbidity in diabetics with autonomic neuropathy. Anesthesiology 1989;70:591–597.

    Article  PubMed  CAS  Google Scholar 

  40. Stoelting RK, Dierdorf SF. Diseases of the nervous system. In: Anesthesia and Coexisting Disease. 3rd ed. New York: Churchill-Livingstone; 1993:346.

    Google Scholar 

  41. Lucas LF, Tsueda K. Cardiovascular depression after brachial plexus block in two diabetic patients with renal failure. Anesthesiology 1990;73:1032–1035.

    Article  PubMed  CAS  Google Scholar 

  42. Adams RD, Victor M. Diseases of the peripheral nerves. In: Principles of Neurology. 4th ed. New York: McGraw-Hill; 1989:1035.

    Google Scholar 

  43. Barash PG, Cullen BF, Stoelting RK. Rare and coexisting disease. In: Clinical Anesthesia. 3rd ed. Philadelphia: JB Lippincott; 2001:491–520.

    Google Scholar 

  44. Lichtenfeld P. Autonomic dysfunction in the Guillain-Barré syndrome. Am J Med 1971; 50:772–780.

    Article  PubMed  CAS  Google Scholar 

  45. McGrady EM. Management of labour and delivery in a patient with Guillian-Barré syndrome. Anaesthesia 1987;42:899.

    Article  PubMed  CAS  Google Scholar 

  46. Connelly M, Shagrin J, Warfleld C. Epidural opioids for the management of pain in a patient with the Guillain-Barré syndrome. Anesthesiology 1990;72:381–383.

    Article  PubMed  CAS  Google Scholar 

  47. Rosenfeld B, Borel C, Hanley D. Epidural morphine treatment of pain in Guillain-Barré syndrome. Arch Neurol 1986;43:1194–1196.

    PubMed  CAS  Google Scholar 

  48. Berger J M, Ontell R. Intrathecal morphine in conjunction with a combined spinal and general anesthetic in a patient with multiple sclerosis. Anesthesiology 1987;66:400–402.

    Article  PubMed  CAS  Google Scholar 

  49. Leigh J, Fearnley SJ, Lupprian KG. Intrathecal diamorphine during laparotomy in a patient with advanced multiple sclerosis. Anaesthesia 1990;45:640–642.

    Article  PubMed  CAS  Google Scholar 

  50. Stoelting RK, Dierdorf SF. Diseases of the nervous system. In: Anesthesia and Coexisting Disease. 3rd ed. New York: Churchill-Livingstone; 1993:436.

    Google Scholar 

  51. Chalkiadis G A, Branch KG. Cardiac arrest after isoflurane anaesthesia in a patient with Duchenne’s muscular dystrophy. Anaesthesia 1990;45:22–25.

    Article  PubMed  CAS  Google Scholar 

  52. Sethna NF, Rockoff MA, Worthen HM, et al. Anesthesia related complications in children with Duchenne’s muscular dystrophy. Anesthesiology 1988;68:462–465.

    Article  PubMed  CAS  Google Scholar 

  53. Wang JM, Stanley TH. Duchenne muscular dystrophy and malignant hyperthermia — 2 case reports. Can Anaesth Soc J 1986;33:492–497.

    Article  PubMed  CAS  Google Scholar 

  54. Duncan PG. Neuromuscular diseases. In: Katz J, Steward DJ, eds. Anesthesia and Uncommon Pediatric Diseases. Philadelphia: WB Saunders; 1987:509–525.

    Google Scholar 

  55. Adams RD, Victor M. The muscular dystrophies. In: Principles of Neurology. 4th ed. New York: McGraw-Hill; 1989:1124.

    Google Scholar 

  56. Adams RD, Victor M. Disorders of muscles characterized by cramp, spasm, pain, and localized masses. In: Principles of Neurology. 4th ed. New York: McGraw-Hill; 1989: 1172–1174.

    Google Scholar 

  57. Stoelting RK, Dierdorf SF. Skin and musculoskeletal diseases. In: Anesthesia and Coexisting Disease. 3rd ed. New York: Churchill-Livingstone; 1993:438.

    Google Scholar 

  58. Mudge BJ, Taylor PB, Vanderspek A FL. Perioperative hazards in myotonic dystrophy. Anaesthesia 1980;35:492–495.

    Article  PubMed  CAS  Google Scholar 

  59. Cope DK, Miller JN. Local and spinal anesthesia for caesarean section in a patient with myotonic dystrophy. Anesth Analg 1986;65:687–690.

    Article  PubMed  CAS  Google Scholar 

  60. Paterson RA, Tousignant M, Skene DS. Caesarean section for twins in a patient with myotonic dystrophy. Can Anaesth Soc J 1985;32:418–421.

    Article  PubMed  CAS  Google Scholar 

  61. Bader A. Neurologic and neuromuscular disease. In: Chestnut DH, ed. Obstetric Anesthesia: Principles and Practice. St. Louis: Mosby; 1994:930.

    Google Scholar 

  62. Marchiori PE, DosReis M, Quevedo ME, et al. Acetylcholine receptor antibody in myasthenia gravis. Acta Neurol Scand 1989;80:387–389.

    Article  PubMed  CAS  Google Scholar 

  63. Hofstad H, Ohm O-J, Mork SJ, et al. Heart disease in myasthenia gravis. Acta Neurol Scand 1984;70:176–184.

    Article  PubMed  CAS  Google Scholar 

  64. Bader A. Neurologic and neuromuscular disease. In: Chestnut DH, ed. Obstetric Anesthesia: Principles and Practice. St. Louis: Mosby; 1994:927.

    Google Scholar 

  65. Leventhal SR, Orkin FK, Hirsh RA. Prediction of the need for postoperative mechanical ventilation in myasthenia gravis. Anesthesiology 1980;53:26–30.

    Article  PubMed  CAS  Google Scholar 

  66. Rolbin SH, Levinson G, Shnider SM, et al. Anesthetic considerations for myasthenia gravis and pregnancy. Anesth Analg 1978;57:441–447.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Intensive Care and Department of Surgery, The Austin Hospital, Victoria, Australia

    Andrea Kattula MB, BS, FANZCA (Anaesthesia Specialist)

  2. Department of Anesthesiology, University of Wisconsin Hospital, Madison, WI, USA

    Giuditta Angelini MD (Assistant Professor) & George Arndt MD (Professor)

Authors
  1. Andrea Kattula MB, BS, FANZCA
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  2. Giuditta Angelini MD
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  3. George Arndt MD
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Editor information

Editors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada

    Brendan T. Finucane MB, BCh, BAO, FRCA, FRCPC (Professor) (Professor)

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Kattula, A., Angelini, G., Arndt, G. (2007). Regional Anesthesia in the Presence of Neurologic Disease. In: Finucane, B.T. (eds) Complications of Regional Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68904-3_20

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  • DOI: https://doi.org/10.1007/978-0-387-68904-3_20

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-37559-5

  • Online ISBN: 978-0-387-68904-3

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