Regional anesthesia techniques in patients with chronic spinal cord injury
Keywords:
regional anesthesia, spinal cord injuriesAbstract
Anesthesia-related complications, such as autonomic dysreflexia, remain an issue in patients with spinal cord injury (SCI). The use of regional anesthesia is an alternative method for the prevention of autonomic dysreflexia that may occur during surgery in SCI patients. In addition, regional anesthesia has been used against neuropathic pain and spasticity. The aim of this study was to investigate the different applications of regional anesthesia in SCI patients. A review of the current literature was performed using the online PUBMED database and using the keywords “regional anesthesia” and “spinal cord injuries”. Initial search results included 183 studies. Finally, 28 studies were included in this review. The results of this study showed that regional anesthesia may be particularly useful for patients with SCI. It may be used for upper and lower limb surgery, abdominal surgery, and obstetrics and particularly for the prevention of autonomic dysreflexia. Moreover, it may be used in the management of chronic neuropathic pain and spasticity in SCI patients. However, more high-quality studies are needed to clarify the benefits of regional anesthesia in the management and rehabilitation of SCI patients.
Downloads
Download data is not yet available.
References
1. Galeiras Vázquez R, Ferreiro Velasco ME, Mourelo Fariña M et al. Update on traumatic acute spinal cord injury. Part 1. Med Intensiva 2017; 41: 237-47.
2. Mourelo Fariña M, Salvador de la Barrera S, Montoto Marqués A et al. Update on traumatic acute spinal cord injury. Part 2. Med Intensiva 2017;41:306-15.
3. McGregor JA, Meeuwsen J. Autonomic hyperreflexia: a mortal danger for spinal cord-damaged women in labor. Am J Obstet Gynecol 1985;151:330-33.
4. Krassioukov A, Warburton DE, Teasell R et al. A systematic review of the management of autonomic dysreflexia after spinal cord injury. Arch Phys Med Rehabil 2009;90:682-95.
5. Blackmer J. Rehabilitation medicine: 1. Autonomic dysreflexia. CMAJ 2003; 169: 931-35.
6. Agostoni M, Giorgi E, Beccaria P et al. Combined spinal-epidural anaesthesia for Caesarean section in a paraplegic woman: difficulty in obtaining the expected level of block. Eur J Anaesthesiol 2000; 17: 329-31.
7. Barker I, Alderson J, Lydon M, Franks CI. Cardiovascular effects of spinal subarachnoid anaesthesia. A study in patients with chronic spinal cord injuries. Anaesthesia 1985; 40: 533-36.
8. Broecker BH, Hranowsky N, Hackler RH. Low spinal anesthesia for the prevention of autonomic dysreflexia in the spinal cord injury patient. J Urol 1979; 122: 366.
9. Burns R, Clark VA. Epidural anaesthesia for caesarean section in a patient with quadriplegia and autonomic hyperreflexia. Int J Obstet Anesth 2004;13:120-23.
10. Cosman BC, Vu TT. Lidocaine anal block limits autonomic dysreflexia during anorectal procedures in spinal cord injury: a randomized, double-blind, placebo-controlled trial. Dis Colon Rectum 2005;48:1556-61.
11. Crosby E, St-Jean B, Reid D et al. Obstetrical anaesthesia and analgesia in chronic spinal cord-injured women. Can J Anaesth 1992; 39: 487-94.
12. Furusawa K, Sugiyama H, Tokuhiro A et al. Topical anesthesia blunts the pressor response induced by bowel manipulation in subjects with cervical spinal cord injury. Spinal Cord 2009; 47: 144-48.
13. Gimovsky ML, Ojeda A, Ozaki R et al. Management of autonomic hyperreflexia associated with a low thoracic spinal cord lesion. Am J Obstet Gynecol 1985; 153: 223-24.
14. Hambly PR, Martin B. Anaesthesia for chronic spinal cord lesions. Anaesthesia 1998; 53: 273-89.
15. Kim BG, Yang C, Lee K et al. Bilateral brachial plexus block in a patient with cervical spinal cord injury: A case report. Medicine (Baltimore) 2020;99: e21126.
16. Ko HY, Kim KT. Treatment of external urethral sphincter hypertonicity by pudendal nerve block using phenol solution in patients with spinal cord injury. Spinal Cord 1997; 35: 690-93.
17. Loubser PG, Donovan WH. Diagnostic spinal anaesthesia in chronic spinal cord injury pain. Paraplegia 1991; 29: 25-36.
18. McCarthy V, Lobay G, Matthey PW. Epidural anesthesia as a technique to control spasticity after surgery in a patient with spinal cord injury. Plast Reconstr Surg 2003; 112: 1729-30.
19. Osgood SL, Kuczkowski KM. Autonomic dysreflexia in a parturient with spinal cord injury. Acta Anaesthesiol Belg 2006; 57: 161-62.
20. Owen MD, Stiles MM, Opper SE et al. Autonomic hyperreflexia in a pregnant paraplegic patient. Case report. Reg Anesth 1994; 19: 415-17.
21. Sharpe EE, Arendt KW, Jacob AK et al. Anesthetic management of parturients with pre-existing paraplegia or tetraplegia: a case series. Int J Obstet Anesth 2015; 24: 77-84.
22. Takatsuki A, Ohtsuka M. Clinical trial of a method for confirming the effects of spinal anesthesia in patients with spinal cord injury. J Anesth 2012; 26: 914-17.
23. Tsai SJ, Lew HL, Date E et al. Treatment of detrusor-sphincter dyssynergia by pudendal nerve block in patients with spinal cord injury. Arch Phys Med Rehabil 2002; 83: 714-17.
24. Uchikawa K, Toikawa H, Liu M. Subscapularis motor point block for spastic shoulders in patients with cervical cord injury. Spinal Cord 2009; 47: 249-51.
25. Yalcin E, Akyuz M, Ilgu O et al. Ultrasonographically guided obturator nerve block for bilateral adductor spasticity in a paraplegic patient. Spinal Cord 2014; 52 Suppl 2: S24-6.
26. Abouleish EI, Hanley ES, Palmer SM. Can epidural fentanyl control autonomic hyperreflexia in a quadriplegic parturient? Anesth Analg 1989;68:523-26.
27. Baraka A. Epidural meperidine for control of autonomic hyperreflexia in a paraplegic parturient. Anesthesiology 1985;62: 688-90.
28. Brian JE, Jr., Clark RB, Quirk JG. Autonomic hyperreflexia, cesarean section and anesthesia. A case report. J Reprod Med 1988; 33: 645-48.
29. Glynn CJ, Jamous MA, Teddy PJ. Cerebrospinal fluid kinetics of epidural clonidine in man. Pain 1992; 49: 361-67.
30. Kobayashi A, Mizobe T, Tojo H, Hashimoto S. Autonomic hyperreflexia during labour. Can J Anaesth 1995; 42: 1134-36.
31. Loubser PG, Akman NM. Effects of intrathecal baclofen on chronic spinal cord injury pain. J Pain Symptom Manage 1996; 12: 241-47.
32. Siddall PJ, Molloy AR, Walker S et al. The efficacy of intrathecal morphine and clonidine in the treatment of pain after spinal cord injury. Anesth Analg 2000; 91: 1493-8.
33. Glynn CJ, Jamous MA, Teddy PJ et al. Role of spinal noradrenergic system in transmission of pain in patients with spinal cord injury. Lancet 1986; 2: 1249-50.
34. Keenan MA, Tomas ES, Stone L, Gerstén LM. Percutaneous phenol block of the musculocutaneous nerve to control elbow flexor spasticity. J Hand Surg Am 1990; 15: 340-6.
35. Kirshblum S. Treatment alternatives for spinal cord injury related spasticity. J Spinal Cord Med 1999; 22: 199-217.
2. Mourelo Fariña M, Salvador de la Barrera S, Montoto Marqués A et al. Update on traumatic acute spinal cord injury. Part 2. Med Intensiva 2017;41:306-15.
3. McGregor JA, Meeuwsen J. Autonomic hyperreflexia: a mortal danger for spinal cord-damaged women in labor. Am J Obstet Gynecol 1985;151:330-33.
4. Krassioukov A, Warburton DE, Teasell R et al. A systematic review of the management of autonomic dysreflexia after spinal cord injury. Arch Phys Med Rehabil 2009;90:682-95.
5. Blackmer J. Rehabilitation medicine: 1. Autonomic dysreflexia. CMAJ 2003; 169: 931-35.
6. Agostoni M, Giorgi E, Beccaria P et al. Combined spinal-epidural anaesthesia for Caesarean section in a paraplegic woman: difficulty in obtaining the expected level of block. Eur J Anaesthesiol 2000; 17: 329-31.
7. Barker I, Alderson J, Lydon M, Franks CI. Cardiovascular effects of spinal subarachnoid anaesthesia. A study in patients with chronic spinal cord injuries. Anaesthesia 1985; 40: 533-36.
8. Broecker BH, Hranowsky N, Hackler RH. Low spinal anesthesia for the prevention of autonomic dysreflexia in the spinal cord injury patient. J Urol 1979; 122: 366.
9. Burns R, Clark VA. Epidural anaesthesia for caesarean section in a patient with quadriplegia and autonomic hyperreflexia. Int J Obstet Anesth 2004;13:120-23.
10. Cosman BC, Vu TT. Lidocaine anal block limits autonomic dysreflexia during anorectal procedures in spinal cord injury: a randomized, double-blind, placebo-controlled trial. Dis Colon Rectum 2005;48:1556-61.
11. Crosby E, St-Jean B, Reid D et al. Obstetrical anaesthesia and analgesia in chronic spinal cord-injured women. Can J Anaesth 1992; 39: 487-94.
12. Furusawa K, Sugiyama H, Tokuhiro A et al. Topical anesthesia blunts the pressor response induced by bowel manipulation in subjects with cervical spinal cord injury. Spinal Cord 2009; 47: 144-48.
13. Gimovsky ML, Ojeda A, Ozaki R et al. Management of autonomic hyperreflexia associated with a low thoracic spinal cord lesion. Am J Obstet Gynecol 1985; 153: 223-24.
14. Hambly PR, Martin B. Anaesthesia for chronic spinal cord lesions. Anaesthesia 1998; 53: 273-89.
15. Kim BG, Yang C, Lee K et al. Bilateral brachial plexus block in a patient with cervical spinal cord injury: A case report. Medicine (Baltimore) 2020;99: e21126.
16. Ko HY, Kim KT. Treatment of external urethral sphincter hypertonicity by pudendal nerve block using phenol solution in patients with spinal cord injury. Spinal Cord 1997; 35: 690-93.
17. Loubser PG, Donovan WH. Diagnostic spinal anaesthesia in chronic spinal cord injury pain. Paraplegia 1991; 29: 25-36.
18. McCarthy V, Lobay G, Matthey PW. Epidural anesthesia as a technique to control spasticity after surgery in a patient with spinal cord injury. Plast Reconstr Surg 2003; 112: 1729-30.
19. Osgood SL, Kuczkowski KM. Autonomic dysreflexia in a parturient with spinal cord injury. Acta Anaesthesiol Belg 2006; 57: 161-62.
20. Owen MD, Stiles MM, Opper SE et al. Autonomic hyperreflexia in a pregnant paraplegic patient. Case report. Reg Anesth 1994; 19: 415-17.
21. Sharpe EE, Arendt KW, Jacob AK et al. Anesthetic management of parturients with pre-existing paraplegia or tetraplegia: a case series. Int J Obstet Anesth 2015; 24: 77-84.
22. Takatsuki A, Ohtsuka M. Clinical trial of a method for confirming the effects of spinal anesthesia in patients with spinal cord injury. J Anesth 2012; 26: 914-17.
23. Tsai SJ, Lew HL, Date E et al. Treatment of detrusor-sphincter dyssynergia by pudendal nerve block in patients with spinal cord injury. Arch Phys Med Rehabil 2002; 83: 714-17.
24. Uchikawa K, Toikawa H, Liu M. Subscapularis motor point block for spastic shoulders in patients with cervical cord injury. Spinal Cord 2009; 47: 249-51.
25. Yalcin E, Akyuz M, Ilgu O et al. Ultrasonographically guided obturator nerve block for bilateral adductor spasticity in a paraplegic patient. Spinal Cord 2014; 52 Suppl 2: S24-6.
26. Abouleish EI, Hanley ES, Palmer SM. Can epidural fentanyl control autonomic hyperreflexia in a quadriplegic parturient? Anesth Analg 1989;68:523-26.
27. Baraka A. Epidural meperidine for control of autonomic hyperreflexia in a paraplegic parturient. Anesthesiology 1985;62: 688-90.
28. Brian JE, Jr., Clark RB, Quirk JG. Autonomic hyperreflexia, cesarean section and anesthesia. A case report. J Reprod Med 1988; 33: 645-48.
29. Glynn CJ, Jamous MA, Teddy PJ. Cerebrospinal fluid kinetics of epidural clonidine in man. Pain 1992; 49: 361-67.
30. Kobayashi A, Mizobe T, Tojo H, Hashimoto S. Autonomic hyperreflexia during labour. Can J Anaesth 1995; 42: 1134-36.
31. Loubser PG, Akman NM. Effects of intrathecal baclofen on chronic spinal cord injury pain. J Pain Symptom Manage 1996; 12: 241-47.
32. Siddall PJ, Molloy AR, Walker S et al. The efficacy of intrathecal morphine and clonidine in the treatment of pain after spinal cord injury. Anesth Analg 2000; 91: 1493-8.
33. Glynn CJ, Jamous MA, Teddy PJ et al. Role of spinal noradrenergic system in transmission of pain in patients with spinal cord injury. Lancet 1986; 2: 1249-50.
34. Keenan MA, Tomas ES, Stone L, Gerstén LM. Percutaneous phenol block of the musculocutaneous nerve to control elbow flexor spasticity. J Hand Surg Am 1990; 15: 340-6.
35. Kirshblum S. Treatment alternatives for spinal cord injury related spasticity. J Spinal Cord Med 1999; 22: 199-217.
Downloads
Published
2021-12-03
Issue
Section
Young Scientists Pages
