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Regional anesthesia in anesthetized or heavily sedated patients
Authors:Bernards Christopher M  Hadzic Admir  Suresh Santhanam  Neal Joseph M
Institution:a Department of Anesthesiology, Virginia Mason Medical Center, Seattle, WA
b Department of Anesthesiology, University of Washington, Seattle, WA
c Department of Anesthesiology, St. Luke's—Roosevelt Hospital Center, New York, NY
d Department of Anesthesiology, Columbia University, New York, NY
e Department of Anesthesiology, Children's Memorial Hospital, Chicago, IL
f Department of Anesthesiology, Northwestern University, Chicago, IL
Abstract:The American Society of Regional Anesthesia and Pain Medicine (ASRA) Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine includes an evidence- and expert opinion-based section on performing procedures on anesthetized or heavily sedated patients. This practice advisory is based on existing scientific literature, pathophysiological principles, and expert opinion. The advisory panel examined the ability of anesthetized or heavily sedated patients to recognize and report intravascular injection of local anesthetic or impending neurologic injury. The advisory panel also considered whether or not the ability to recognize and report symptoms could actually affect the occurrence of nerve injury or local anesthetic systemic toxicity. The advisory contains recommendations pertaining to both adult and pediatric patients.
Keywords:Nerve injury  Regional anesthesia  Pain medicine  Local anesthetic toxicity  Peripheral nerve block
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