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Gasbag Anaesthesia Forums

Anesthesia Discussion => Ask an Expert - Case Studies => Topic started by: koorosh on July 22, 2007, 07:24:52 PM

Title: have you ever anesthesia any multiple scelerosis pregnanet patient
Post by: koorosh on July 22, 2007, 07:24:52 PM
i have a pregnant patient with multiple sclerosis which method is better for her?
Title: Re: have you ever anesthesia any multiple scelerosis pregnanet patient
Post by: Krishnendu Chaudhuri on July 24, 2007, 01:31:21 AM
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.
Title: Re: have you ever anesthesia any multiple scelerosis pregnanet patient
Post by: frontier on July 31, 2007, 10:55:24 AM
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.
Title: Re: have you ever anesthesia any multiple scelerosis pregnanet patient
Post by: yogenbhatt1 on August 01, 2007, 02:06:26 PM
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.
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