Regional anesthesia in patients with pre-existing neurologic disease.

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.