Regional Anesthesia in Patients With Preexisting Neurologic Disease

Kopp, Sandra L.; Jacob, Adam K.; Hebl, James R.

doi:10.1097/aap.0000000000000179

Cited by 60 publications

(55 citation statements)

References 127 publications

(132 reference statements)

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“…Manuscripts were first peer reviewed internally by at least 3 members of the advisory panel and subsequently peer reviewed externally using this journal's standard peer review process. 4 Individual supporting articles [10][11][12][13][14][15][16] describe the specific search methodology used to research that topic. In general, standard search engines and cross-referenced citations provided the literature basis for the updated material contained within this review.…”

Section: Methodsmentioning

confidence: 99%

“…However, major concerns include the potential for autonomic instability and consequent exaggerated responses to neuraxial blockade and reactivation of previously dormant GBS symptoms, both of which have been reported. 16 There are too few data to make recommendations on GBS and concurrent regional anesthetic techniques other than to suggest that decisions be made on an individualized basis that accounts for risk and benefit.…”

Section: Inflammatory Neuropathiesmentioning

confidence: 99%

“…A few case reports attest to the apparent safety of neuraxial or peripheral blockade in ALS patients, 16 but these reports are insufficient for general recommendations. As with other CNS preexisting diseases, the risk and benefit of regional techniques should be balanced against those of general anesthesia.…”

Section: Amyotrophic Lateral Sclerosismentioning

confidence: 99%

“…Practitioners are encouraged to read the supporting articles that accompany this summary; they contain the details on which individual recommendations are based. [10][11][12][13][14][15][16] "Consistent with a recent editorial call to focus practice advisory and consensus conference updates on new material, 17 most supporting articles for individual topics considered by this advisory are built on 2 components. First, to provide perspective, those topics and associated recommendations for which no substantially new knowledge has emerged are reviewed briefly.…”

mentioning

confidence: 99%

See 3 more Smart Citations

The Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine

Neal¹,

Barrington

Brull

et al. 2015

Regional Anesthesia and Pain Medicine

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391

240

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The Second American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine updates information that was originally presented at the Society's first open forum on this subject (2005) and published in 2008. Portions of the second advisory were presented in an open forum (2012) and are herein updated, with attention to those topics subject to evolving knowledge since the first and second advisory conferences. The second advisory briefly summarizes recommendations that have not changed substantially. New to this iteration of the advisory is information related to the risk of nerve injury inherent to common orthopedic surgical procedures. Recommendations are expanded regarding the preventive role of various monitoring technologies such as ultrasound guidance and injection pressure monitoring. New clinical recommendations focus on emerging concerns including spinal stenosis and vertebral canal pathologies, blood pressure management during neuraxial anesthesia, administering blocks in anesthetized or deeply sedated patients, patients with preexisting neurologic disease, and inflammatory neuropathies. An updated diagnostic and treatment algorithm is presented.

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Section: Methodsmentioning

confidence: 99%

Section: Inflammatory Neuropathiesmentioning

confidence: 99%

Section: Amyotrophic Lateral Sclerosismentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

The Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine

Neal¹,

Barrington

Brull

et al. 2015

Regional Anesthesia and Pain Medicine

Self Cite

391

240

View full text Add to dashboard Cite

show abstract

“…9,11,12 As a first step in investigating this question, we decided to study patients without preexisting neuropathy following peripheral nerve blocks using Semmes-Weinstein monofilament testing to detect subclinical neuropathy. Semmes-Weinstein monofilament testing is a threshold dependent method of measuring changes in light touch, which is thought to be a very sensitive indicator of neuropathy.…”

Section: Introductionmentioning

confidence: 99%

Brachial Plexus Blockade Causes Subclinical Neuropathy

Perretta

Gotlin

Brock

et al. 2016

Hand (New York, N,Y.)

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Background: The objective of this study is to determine subclinical changes in hand sensation after brachial plexus blocks used for hand surgery procedures. We used Semmes-Weinstein monofilament testing to detect these changes. We hypothesized that patients undergoing brachial plexus nerve blocks would have postoperative subclinical neuropathy detected by monofilament testing when compared with controls. Methods: In total, 115 hand surgery adult patients were prospectively enrolled in this study. All patients undergoing nerve-related procedures were excluded as well as any patients with preoperative clinically apparent nerve deficits. Eighty-four patients underwent brachial plexus blockade preoperatively, and 31 patients underwent general anesthesia (GA). Semmes-Weinstein monofilament testing of the hand was performed preoperatively on both the operative and nonoperative extremities and postoperatively at a mean of 11 days on both hands. Preoperative and postoperative monofilament testing scores were compared between the block hand and the nonoperated hand of the same patient, as well as between the block hands and the GA-operated hands. Results: There were no recorded clinically relevant neurologic complications in the block group or GA group. A statistically significant decrease in sensation in postoperative testing in the operated block hand compared with the nonoperated hand was noted. When comparing the operated block hand with the operated GA hand, there was a decrease in postoperative sensation in the operated block hand that did not reach statistical significance. Conclusions: Brachial plexus blockade causes subtle subclinical decreases in sensibility at short-term follow-up, without any clinically relevant manifestations.

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Exaggerated activities of TRPM7 underlie bupivacaine‐induced neurotoxicity in the SH‐SY5Y cells preconditioned with high glucose

Dai

Hong

et al. 2021

J Biochem & Molecular Tox

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Hyperglycemia is considered a risk factor for the enhancement of local anesthetic‐induced neurotoxicity. Transient receptor potential melastatin 7 (TRPM7), a kinase‐coupled cation channel, has been implicated in a variety of neuropathological processes, including intracellular calcium disturbance and high glucose‐induced neuropathy. In this study, we investigated whether TRPM7‐related pathophysiology is involved in bupivacaine‐induced neurotoxicity in SH‐SY5Y cells and how hyperglycemia acts as a risk factor. For initial neurotoxicity evaluation, it was confirmed that cell damage and apoptosis induced by acute exposure to bupivacaine were dependent on its concentration and glucose preconditioning. High glucose preconditioning facilitated the bupivacaine‐induced fast and temporary rise in intracellular free calcium concentration ([Ca2+]i), which was attributed to both calcium influx through TRPM7 and calcium store release. Additionally, bupivacaine was shown to increase TRPM7‐like currents, particularly in cells preconditioned with high glucose. Bupivacaine‐induced neurotoxicity in hyperglycemia was correlated with extracellular signal‐regulated kinase (ERK), but not protein kinase B (AKT) activation. Inhibition of TRPM7 and ERK activity alleviates bupivacaine neurotoxicity. These results suggest that therapeutically targeting TRPM7‐related pathophysiological changes could be a potential strategy for treating local anesthetic‐induced neurotoxicity exacerbated by hyperglycemia.

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Regional Anesthesia in Patients With Preexisting Neurologic Disease

Cited by 60 publications

References 127 publications

The Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine

The Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine

Brachial Plexus Blockade Causes Subclinical Neuropathy

Exaggerated activities of TRPM7 underlie bupivacaine‐induced neurotoxicity in the SH‐SY5Y cells preconditioned with high glucose

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