Regional anesthesia can often provide safe and effective pain control for surgery or other procedures. However, it be contraindicated if certain conditions are present.



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




• 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.


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