have you ever anesthesia any multiple scelerosis pregnanet patient

Started by koorosh, July 22, 2007, 07:24:52 PM

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koorosh

i have a pregnant patient with multiple sclerosis which method is better for her?

Krishnendu Chaudhuri

The literature says there is very little increased risk with a block. However ther are also reports of increased duration of blocks. On balance, I would be reluctant to give a central neuraxial block in a patient who already has a demyelinated spinal cord.

frontier

hi,
its not advisable at all to give spinal in multiple sclerosis patient as spinal cord without sheath & demyelinated will lead to neurotoxicity by bupivacaine or whatsoever drug used.even epidural block also not safe.

yogenbhatt1

Hi,
That is a good trap you have laid. Trying to give a central neuraxial block will be almost beyond thinking, with all unsheethed nerve bundles.
Have you given a thought to intrathecal Pentazocine, Fentanyl( acts much shorter about 20 mins only) or even Ketamine intrathecally?
I have tried all these combinations for some thing or other, they were good enough. But for MS, I do not know.
I wonder if these narcotics may be safe? I am sure some will read this and get back to us.