Related Experiment Video
Updated: May 11, 2026
03:14
Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
Published on: January 31, 2025
[Spinal anesthesia for cesarean section in a patient with multiple sclerosis]
Sueko Oouchi1, Hirofumi Nagata, Haruo Ookawa
1Department of Anesthesiology, School of Medicine, Iwate Medical University, Morioka 020-8505.
Masui. the Japanese Journal of Anesthesiology
|May 24, 2013
Summary
Spinal anesthesia may be safe for patients with multiple sclerosis (MS) in remission. This case study found no MS relapse after a patient with stable multiple sclerosis received spinal anesthesia for cesarean delivery.
Area of Science:
- Anesthesiology
- Neurology
Background:
- Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system.
- Spinal anesthesia is often considered contraindicated in patients with MS due to concerns about exacerbating neurological symptoms.
Observation:
- A 29-year-old woman with a history of multiple sclerosis (MS) in remission underwent an urgent cesarean section.
- She received spinal anesthesia using a 27 G needle and 0.5% hyperbaric bupivacaine.
- The sensory blockade reached T4, and the cesarean section proceeded without immediate complications.
Findings:
- The patient experienced no recognized MS relapse in the 19 months following the procedure.
- This suggests that spinal anesthesia did not trigger a new MS exacerbation in this case.
Implications:
- Spinal anesthesia may be a viable option for pregnant patients with multiple sclerosis in a stable, remission state.
- Further research is warranted to confirm the safety and efficacy of spinal anesthesia in this patient population.
Related Concept Videos
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:24General Anesthesia: Overview
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:31Skeletal Muscle Relaxants: Therapeutic Uses
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.