Regional anaesthesia in the patient with pre-existing neurological dysfunction

  • T. T. Horlocker


Patients with pre-existing neurological disease present a unique challenge to the anaesthesiologist. The cause of postoperative neurological deficits is difficult to evaluate, because neural injury may occur as a result of surgical trauma, tourniquet pressure, prolonged labour, or improper patient positioning or anaesthetic technique. Progressive neurological diseases such as multiple sclerosis may coincidentally worsen perioperatively, independently of the anaesthetic method. The most conservative legal approach is to avoid regional anaesthesia in these patients. However, high-risk patients, including those with significant cardiopulmonary disease, may benefit medically from regional anaesthesia and analgesia. The decision to proceed with regional anaesthesia in these patients should be made on a case-by-case basis. Meticulous regional anaesthetic technique should be observed to minimise further neurological injury.


Multiple Sclerosis Spinal Stenosis Neurological Injury Dural Puncture Cauda Equina Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • T. T. Horlocker
    • 1
  1. 1.Department of Anesthesiology and OrthopedicsMayo Clinic College of MedicineRochesterUSA

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