• Minerva anestesiologica · Nov 2013

    Neuraxial anaesthesia in patients with intracranial hypertension or cerebrospinal fluid shunting systems: what the anaesthetist should know?

    • H Bouaziz, U McNelis, J Raft, M R Losser, and O Klein.
    • Department of Anaesthesiology, Maternity Hospital, University Hospital of Nancy, France - h.bouaziz@chu-nancy.fr.
    • Minerva Anestesiol. 2013 Nov 26.

    AbstractThe management of patients with central nervous system disorders such as brain tumours, hydrocephalus, intracranial hypertension, or subarachnoid haemorrhage has improved in recent years resulting in increased life expectancy. Consequently, the prevalence of patients with increased intracranial pressure or cerebrospinal fluid shunting devices presenting for non-neurological procedures has increased. These patients commonly receive a general anaesthetic, as the safety profile of neuraxial anaesthesia in this clinical setting remains uncertain. This article reviews literature on neuraxial anaesthesia in patients with intracranial hypertension or cerebrospinal fluid shunting systems. It describes current knowledge, exposes and weighs the real benefits and risks of this technique in this setting. It provides several scenarios and anaesthetic options to help the practitioner with choosing a tailored approach in this specific population.

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