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Essentials of Regional Anesthesia pp 541–556Cite as

Regional Anesthesia for Chronic Disease States

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Abstract

Historically, the use of regional anesthetic techniques in patients with preexisting central nervous system (CNS) disorders has been considered relatively contraindicated. Probably, the most conservative legal approach in these patients is to avoid regional anesthesia. The recommendations of Vandam and Dripps in 1956 were to avoid spinal anesthesia in patients with preexisting CNS disorders, and these recommendations have greatly influenced the clinical management of these patients for the last several decades. The cause of postoperative neurological disorders is multifactorial and is usually difficult to evaluate because of the many patients and surgical and anesthetic risk factors that may play a role, Table 21.1 [1]. Therefore, the abundance of contributing factors makes it extremely difficult for clinicians and investigators alike to reliably isolate the effect of anesthetic technique on neurologic outcome.

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References

  1. Horlocker TT. Regional anaesthesia in the patient with pre-existing neurological dysfunction. In: Gullo A, editor. Anaesthesia, pain, intensive care and emergency A.P.I.C.E. Milan: Springer; 2007. p. 325–36.

    Chapter  Google Scholar 

  2. Heytens M, Vercauteren L. Anaesthetic considerations for patients with a pre-existing neurological deficit: are neuraxial techniques safe? Acta Anaesthesiol Scand. 2007;51:831–8.

    Article  PubMed  Google Scholar 

  3. Kopp SL, Wynd KP, Horlocker TT, et al. Regional blockade in patients with a history of a seizure disorder. Anesth Analg. 2009;109:272–8.

    Article  PubMed  Google Scholar 

  4. Hebel JR, Horlocker TT, Schroeder DR. Neuraxial anesthesia and analgesia in patients with preexisting central nervous system disorders. Anesth Analg. 2006;103:223–8.

    Article  Google Scholar 

  5. Kattula A, Angelini G, Arndt G. Regional anesthesia in the presence of neurologic disease. In: Brendan T, editor. Finucane: complications of regional anesthesia. 2nd ed. New York: Springer; 2007. p. 373–85.

    Chapter  Google Scholar 

  6. Neal JM, Bernards CM, Hadzic A, et al. ASRA practice advisory on neurologic complications in Regional Anesthesia and Pain Medicine. Reg Anesth Pain Med. 2008;33:404–15.

    PubMed  Google Scholar 

  7. Goulart AP, Moro ET, Rios Rde P, Pires RT. Subarachnoid blockade for cesarean section in a patient with ventriculoperitoneal shunt: case report. Rev Bras Anestesiol. 2009;59:471–5.

    Article  PubMed  Google Scholar 

  8. Kachko L, Platis CM, Livni G, et al. Spinal anesthesia in infants with ventriculoperitoneal shunt: report of five cases and review of literature. Paediatr Anaesth. 2005;16:578–83.

    Google Scholar 

  9. Go AS, Browner WS. Cardiac outcomes after regional or general anesthesia, do we have the answer? Anesthesiology. 1996;84:1–2.

    Article  PubMed  CAS  Google Scholar 

  10. Liu S, Carpenter R, Neal J. Epidural anesthesia and analgesia: their role in postoperative outcome. Anesthesiology. 1995;82:1474–506.

    Article  PubMed  CAS  Google Scholar 

  11. Yaeger M, Glass DD, Neft RK, et al. Epidural anesthesia and analgesia in high risk surgical patients. Anesthesiology. 1987;66:729–36.

    Article  Google Scholar 

  12. McDonald SB. Is neuraxial blockade contraindicated in the patient with aortic stenosis? Reg Anesth Pain Med. 2004;29:496–502.

    PubMed  Google Scholar 

  13. Lawrence VA, Cornell JE, Smetana GW. Strategies to reduce postoperative pulmonary complications after noncardiothoracic surgery: systematic review for the American College of Physicians. Ann Intern Med. 2006;144:596–608.

    PubMed  Google Scholar 

  14. Rosenberg H, Veering BTh, Urmey WF. Maximum recommended doses of local anesthetics: a multifactorial concept. Reg Anesth Pain Med. 2004;29:564–75.

    PubMed  CAS  Google Scholar 

  15. Amitrano L, Guardascione MA, Brancaccio V, et al. Coagulation disorders in liver disease. Semin Liver Dis. 2002;22:83–96.

    Article  PubMed  CAS  Google Scholar 

  16. Boccardo P, Remuzzi G, Galbusera M. Platelet dysfunction in renal failure. Semin Throm Hemost. 2004;30:579–89.

    Article  CAS  Google Scholar 

  17. Horlocker TT, Wedel D, Rowlingson J, Enneking F, Kopp S, Benzon H, et al. ASRA practice advisory. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy. American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines. 3rd edition. Reg Anesth Pain Med. 2010;35:64–101.

    Article  PubMed  CAS  Google Scholar 

  18. Beilin Y, Zahn J, Comerford M. Safe epidural analgesia in thirty parturients with platelet counts between 69,000 and 98,000/mm3. Anesth Analg. 1997;85:385–8.

    PubMed  CAS  Google Scholar 

  19. Van Veen JJ, Nokes TJ, Makris M. The risk of spinal hematoma following neuraxial anesthesia or lumbar puncture in thrombocytopenic individuals. Br J Hematol. 2010;148:15–25.

    Article  Google Scholar 

  20. Horlocker TT, Wedel DJ. Regional anesthesia in the immunocompromised patient. Reg Anesth Pain Med. 2006;31:334–45.

    PubMed  Google Scholar 

  21. Practice advisory for the prevention, diagnosis, and management of infectious complications associated with neuraxial techniques: a report by the American Society of Anesthesiologists task force on infectious complications associated with neuraxial techniques. Anesthesiology. 2010;112:530–45.

    Google Scholar 

  22. Mar GJ, Barrington MJ, McGuirk BR. Acute compartment syndrome of the lower limb and the effect of postoperative analgesia on diagnosis. Br J Anaesth. 2009;102:3–11.

    Article  PubMed  CAS  Google Scholar 

  23. Paqueron X, Boccara G, Bendahou M, Coriat P, Riou B. Brachial plexus nerve block exhibits prolonged duration in the elderly. Anesthesiology. 2002;97:1245–9.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 3325, Los Angeles, CA, 90095-7403, USA

    Siamak Rahman MD & Parisa Partownavid MD

Authors
  1. Siamak Rahman MD
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  2. Parisa Partownavid MD
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Correspondence to Siamak Rahman MD .

Editor information

Editors and Affiliations

  1. University Hosp and Ochsner Kenner Hosp, Prof and Chairman,Dept of Anesthesiology, Director of Interventional Pain Mgmt., Louisiana State University School of Medicine, New Orleans, 70112, USA

    Alan David Kaye

  2. Harvard Medical School, Director, Proced Sedation Mgmt & Safety, Assistant Professor of Anesthesia, Anesthesiology, Perioperative & Pain Med, Boston, 02115, USA

    Richard D. Urman

  3. Yale University School of Medicine, Associate Professor of Anesthesiology, New Haven, 06520, Connecticut, USA

    Nalini Vadivelu

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Rahman, S., Partownavid, P. (2012). Regional Anesthesia for Chronic Disease States. In: Kaye, A., Urman, R., Vadivelu, N. (eds) Essentials of Regional Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1013-3_21

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  • DOI: https://doi.org/10.1007/978-1-4614-1013-3_21

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-1012-6

  • Online ISBN: 978-1-4614-1013-3

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