Regional anesthesia can often provide safe and effective pain control for surgery or other procedures. However, it be contraindicated if certain conditions are present.
|
Contraindication |
Response |
|
excessive patient anxiety |
consider sedation |
|
lack of patient consent |
|
|
regional anesthesia may interfere with or be inappropriate for the procedure |
|
|
severe bleeding disorder |
treat coagulopathy if cause can be found |
|
infection at the site of block |
|
|
other serious infections (sepsis, meningitis) |
|
|
severe mental illness |
consult with a psychiatrist |
|
distorted anatomy from congenital anomalies or acquired disorders |
|
|
lack of skill on the part of the anesthetist |
schedule a trained provider |
|
neurologic disease that may be aggravated by regional block (see below) |
|
|
allergy to anesthetic |
select an alternative agent |
|
danger of compartment syndrome at site to be anesthetized |
|
|
inadequate monitoring during the procedure |
provide adequate monitoring by a trained nurse or provider |
|
history of serious complication after regional anesthesia that is likely to recur |
|
where:
• Neurologic diseases that may be made worse by regional anesthesia include multiple sclerosis, poliomyelitis, nerve trauma and muscular dystrophy. However, Dalens (2000) mentions that this may not be evidence-based.
Specialty: Anesthesiology, Neurology, Surgery, orthopedic
