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Korean Journal of Anesthesiology 2009;57(3):367-370.
DOI: https://doi.org/10.4097/kjae.2009.57.3.367   
Combined spinal-epidural anesthesia for caesarian section in a patients with multiple sclerosis: A case report.
Ae Ryoung Lee, Sun Ji Hyun, Duck Hwan Choi
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dhchoi@skku.edu
Abstract
The use of neuroaxial blocks in patients with multiple sclerosis has been controversial, because the effect of local anesthetic drugs on the course of the disease is unclear. We report an obstetric patient with multiple sclerosis whose caesarian section was performed successfully under combined spinal-epidural anesthesia and postoperative pain control was managed using patient-controlled epidural analgesia. There were no exacerbation of neurologic symptoms and no relapse of disease at two month follow-up. We suggest that the choice of anesthetic technique for patients with multiple sclerosis should be determined after evaluation of the course of the disease and informed consent. The obstetric patients with multiple sclerosis should not be denied the neuroaxial block for labor and caesarian section.
Key Words: Caesarian section; Combined spinal-epidural; Multiple sclerosis


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