Hadzic's Regional Anesthesia > Part VIII. Regional Anesthesia in Patients with Special Considerations > Chapter 59. Regional Anesthesia in the Patient with Preexisting Neurologic Disease Steven Deschner, MD

Regional Anesthesia in the Patient with Preexisting Neurologic Disease: Introduction

"Patients with preexisting neurologic disease present a unique challenge to the anesthesiologist. Knowledge of the pathophysiology of the disease and the effect of anesthetic drug therapy on the disease process is essential for the safe management of anesthesia for these patients. Both active and dormant neurologic diseases may worsen in the perioperative period, independent of the chosen anesthetic method. However when regional techniques are used, the cause of postoperative neurologic deficits may be difficult to evaluate as neural injury can be related to a wide variety of reasons, ie, surgical trauma, tourniquet pressure, improper positioning, or anesthetic technique.¹ The possibility of needle-induced trauma, local anesthetic toxicity, or neural tissue ischemia or damage during regional anesthesia has led many anesthesiologists to avoid regional techniques in patients with underlying neurologic diseases...."