Bornemann-Cimenti Helmar, Sivro Nikki, Toft Frederike, Halb Larissa, Sandner-Kiesling Andreas
Medical University of Graz, Department of Anaesthesiology and Intensive Care Medicine, Graz, Áustria.
Medical University of Graz, Department of Anaesthesiology and Intensive Care Medicine, Graz, Áustria.
Rev Bras Anestesiol. 2017 Jul-Aug;67(4):404-410. doi: 10.1016/j.bjan.2016.09.015. Epub 2017 May 19.
Current guidelines for neuraxial analgesia in patients with multiple sclerosis are ambiguous and offer the clinician only a limited basis for decision making. This systematic review examines the number of cases in which multiple sclerosis has been exacerbated after central neuraxial analgesia in order to rationally evaluate the safety of these procedures.
A systematic literature search with the keywords "anesthesia or analgesia" and "epidural, peridural, caudal, spinal, subarachnoid or intrathecal" in combination with "multiple sclerosis" was performed in the databases PubMed and Embase, looking for clinical data on the effect of central neuraxial analgesia on the course of multiple sclerosis.
Over a period of 65 years, our search resulted in 37 reports with a total of 231 patients. In 10 patients multiple sclerosis was worsened and nine multiple sclerosis or neuromyelitis optica was first diagnosed in a timely context with central neuraxial analgesia. None of the cases showed a clear relation between cause and effect. Current clinical evidence does not support the theory that central neuraxial analgesia negatively affects the course of multiple sclerosis.
