Neal JM

Language: English
References: 3
Page: 248-251
PDF size: 207.86 Kb.

Text Extraction

Regional anesthesia and analgesia are safe in part because associated neurologic complications are exceedingly rare. Yet when neurologic complications occur in this setting they are often life altering, especially when involving the neuraxis. Since August Bier’s first spinal anesthetic in 1898, anesthesiologists have sought to minimize neurologic complications.

This presentation aims to take a circumspect look at neurologic complications associated with regional anesthesia and to critically appraise our success in eliminating them. During the course of this analysis, I intend to made several key points:

• Regional anesthesia has experience cyclical approval or condemnation as specific neurologic complications have been identified and addressed.
• Overall, it is difficult to see meaningful reduction in many neurologic complications. This occurs in part because as we demonstrate safety with a procedure, we tend to extend its use to patients who are at higher risk for complications.

REFERENCES

1. Kopp SL, Jacob AK, Hebl JR. Regional anesthesia in patients with pre-existing neurologic disease. Reg Anesth Pain Med. 2015;40:467-478.

2. Neal JM, Kopp SL, Lanier WL, Pasternak JJ, Rathmell JP. Anatomy and pathophysiology of spinal cord injury associated with regional anesthesia and pain medicine: 2015 update. Reg Anesth Pain Med. 2015;40:506-525.

3. Neal JM, Barrington MJ, Brull R, et al. The second ASRA practice advisory on neurologic complications associated with regional anesthesia and pain medicine: Executive summary, 2015. Reg Anesth Pain Med 2015;40:401-430.