Regional Anesthesia in Patients With Preexisting Neurologic Disease
Regional Anesthesia in Patients With Preexisting Neurologic Disease
复制标题
DOI：
10.1097/aap.0000000000000179
复制
发表时间：
2015-09-01
影响因子：
5.1
通讯作者：
Hebl, James R.
中科院分区：
文献类型：
--
作者：
Kopp, Sandra L.;Jacob, Adam K.;Hebl, James R.
新增功能：自2008年发表初步建议以来，关于既存神经系统疾病患者局部麻醉性能的新信息有限。然而，自2008年以来，关于（1）糖尿病神经对局部麻醉剂更敏感，可能更容易受伤的问题和（2）对既存椎管病变患者进行轴索麻醉和镇痛可能增加新发或恶化神经系统症状的风险的问题的证据强度有所增加。这一增加的证据强化了我们最初的建议。此外，自2008年首次提出建议以来，已描述了术后炎性神经病的概念，并且可能是术后神经功能障碍的一个促成因素。
What's New: Since publication of initial recommendations in 2008, there is limited new information regarding the performance of regional anesthesia in patients with preexisting neurologic diseases. However, the strength of evidence has increased since 2008 regarding (1) the concern that diabetic nerves are more sensitive to local anesthetics and perhaps more susceptible to injury and (2) the concern that performing neuraxial anesthesia and analgesia in patients with preexisting spinal canal pathology may increase the risk of new or worsening neurologic symptoms. This increased evidence reinforces our initial recommendations. In addition, since the initial recommendations in 2008, the concept of postsurgical inflammatory neuropathy has been described and is potentially a contributor to postoperative neurologic dysfunction.