Anestesia neuraxial em pacientes com esclerose múltipla – uma revisão sistemática

Bornemann‐Cimenti, Helmar; Sivro, Nikki; Toft, Frederike; Halb, L.; Sandner‐Kiesling, Andreas

doi:10.1016/j.bjan.2016.09.015

Cited by 13 publications

(6 citation statements)

References 37 publications

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“…Subarachnoid anesthesia has been postulated to exacerbate MS attacks due to the toxic effects of local anesthetics on demyelinated neurons. However, in a systematic review of neuraxial anesthesia in obstetric patients with MS, Bornemann-Cimenti et al 5 suggest that this mechanism of action is hypothetical and evidence is based on only a few case reports without a clear correlation between subarachnoid anesthesia and MS exacerbations. In addition, they report multiple incidences of spinal and epidural anesthesia in obstetric patients with MS with no negative outcomes.…”

Section: Discussionmentioning

confidence: 99%

Novel Treatment Using Intravenous Dantrolene Sodium for Postoperative Exacerbated Spasticity in Multiple Sclerosis: A Case Report

Sturgill

Wittwer²

2018

A&A Practice

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Patients with upper motor neuron disease, such as multiple sclerosis, can present with severe spasticity in the perioperative period. In most cases, this can be managed with a combination of preoperative oral medications, regional or neuraxial anesthetic techniques, and intravenous muscle relaxants. We describe the clinical presentation of a patient with multiple sclerosis and the successful use of intravenous dantrolene sodium postoperatively for the treatment of exacerbated spasticity refractory to traditional management.

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Section: Discussionmentioning

confidence: 99%

Novel Treatment Using Intravenous Dantrolene Sodium for Postoperative Exacerbated Spasticity in Multiple Sclerosis: A Case Report

Sturgill

Wittwer²

2018

A&A Practice

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“…Though MS is a distinct entity from NMO, the current literature has similarly shown no relationship between exacerbations of MS and neuraxial anesthesia. Two prospective studies evaluating the safety of epidural anesthesia in obstetric patients failed to show any negative outcomes [14]. A systematic review of 231 patients with MS also found no evidence that neuraxial anesthesia negatively affects the course of MS [14].…”

Section: Discussionmentioning

confidence: 99%

“…Two prospective studies evaluating the safety of epidural anesthesia in obstetric patients failed to show any negative outcomes [14]. A systematic review of 231 patients with MS also found no evidence that neuraxial anesthesia negatively affects the course of MS [14]. There are only case reports about spinal anesthesia and MS, but they also do not show a clear negative relationship.…”

Section: Discussionmentioning

confidence: 99%

Epidural Labor Analgesia for a Patient with Neuromyelitis Optica: A Case Report and Review of the Literature

Chang

Chung

Vandse

2018

Case Reports in Anesthesiology

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Neuromyelitis optica (NMO) is a rare demyelinating disorder affecting the spinal cord and optic nerves. Like multiple sclerosis (MS), it predominantly affects women during childbearing years. The impact of neuraxial anesthesia on the course of NMO is uncertain. There are no large studies available to draw definitive conclusions regarding the safety of neuraxial anesthesia in this population. A review of the current literature suggests that neuraxial anesthesia is unlikely to exacerbate neurologic symptoms in pregnant patients with NMO. However, given the rarity of this disease entity among patients requesting epidural labor analgesia, we recommend taking a cautious approach.

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“…There are no reported negative outcomes from the use of epidural, peridural, caudal, spinal, subarachnoid or intrathecal analgesia in MS [ 46 ]. Epidural analgesia can be safely used in women with MS who are giving birth [ 47 ].…”

Section: The Effect Of Ms On Obstetric Neonatal and Delivery Outcomementioning

confidence: 99%

Practical Evidence-Based Recommendations for Patients with Multiple Sclerosis Who Want to Have Children

et al. 2018

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Multiple sclerosis (MS) management presently aims to reach a state of no (or minimal) evidence of disease activity. The development and commercialization of new drugs has led to a renewed interest in family planning, since patients with MS may face a future with reduced (or no) disease-related neurological disability. The advice of neurologists is often sought by patients who want to have children and need to know more about disease control at conception and during pregnancy and the puerperium. When MS is well controlled, the simple withdrawal of drugs for patients who intend to conceive is not an option. On the other hand, not all treatments presently recommended for MS are considered safe during conception, pregnancy and/or breastfeeding. The objective of the present study was to summarize the practical and evidence-based recommendations for family planning when our patients (women and men) have MS.Funding TEVA Pharmaceutical Brazil.

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Anestesia neuraxial em pacientes com esclerose múltipla – uma revisão sistemática

Cited by 13 publications

References 37 publications

Novel Treatment Using Intravenous Dantrolene Sodium for Postoperative Exacerbated Spasticity in Multiple Sclerosis: A Case Report

Novel Treatment Using Intravenous Dantrolene Sodium for Postoperative Exacerbated Spasticity in Multiple Sclerosis: A Case Report

Epidural Labor Analgesia for a Patient with Neuromyelitis Optica: A Case Report and Review of the Literature

Practical Evidence-Based Recommendations for Patients with Multiple Sclerosis Who Want to Have Children

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