Regional anesthesia can often provide safe and effective pain control for surgery or other procedures. However, it be contraindicated if certain conditions are present.
Contraindication
Response
excessive patient anxiety
consider sedation
lack of patient consent
regional anesthesia may interfere with or be inappropriate for the procedure
severe bleeding disorder
treat coagulopathy if cause can be found
infection at the site of block
other serious infections (sepsis, meningitis)
severe mental illness
consult with a psychiatrist
distorted anatomy from congenital anomalies or acquired disorders
lack of skill on the part of the anesthetist
schedule a trained provider
neurologic disease that may be aggravated by regional block (see below)
allergy to anesthetic
select an alternative agent
danger of compartment syndrome at site to be anesthetized
inadequate monitoring during the procedure
provide adequate monitoring by a trained nurse or provider
history of serious complication after regional anesthesia that is likely to recur
where:
• Neurologic diseases that may be made worse by regional anesthesia include multiple sclerosis, poliomyelitis, nerve trauma and muscular dystrophy. However, Dalens (2000) mentions that this may not be evidence-based.
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