Multiple sclerosis and anesthetic implications.
OBJECTIVE
Multiple sclerosis remains prevalent among young women in the United States of America. It is a disease of the central nervous system that possesses many anesthetic implications. Anesthesia providers need to understand this disorder and its multiple anesthetic ramifications.


RESULTS
Recent work has provided more insight into the etiology of multiple sclerosis, its pathogenesis, diagnosis and natural history. A number of new medications have also been added to the therapeutic armamentarium. Optimal anesthetic care entails a thorough preoperative evaluation, medication history and neurologic examination, intraoperative awareness of conditions that may precipitate attacks and lead to potentially life-threatening complications, as well as postoperative attention to respiratory and other risks. Recommendations for management are based on information from small retrospective studies and anecdotal reports.


CONCLUSIONS
In summary, our aim is to provide an updated view of multiple sclerosis from the perspective of perioperative care, emphasizing interactions between the disease, surgery and anesthesia.
Dorotta
Ihab R
IR
Department of General Anesthesiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA. Dorotti@ccf.org
Schubert
Armin
A