title: Regional anesthetic procedures in immunosuppressed patients:  risk of infection.
abstract: OBJECTIVE
  Due to demographic developments anesthesiologists encounter an increasing number of older and multimorbid patients in their daily routine. Consequently the proportion of immunosuppressed patients (e.g. those with cancer, diabetes mellitus, and those receiving immunosuppressive treatment and/or chemotherapy - e.g. for inflammatory bowel diseases, autoimmune diseases, and after transplantation) will also rise. Regional anesthesia (peripheral nerve blocks and neuraxial blockade) may be beneficial in these patients and will have to be considered in order to provide adequate pain management and minimize risks for the patients.
  
  
  RESULTS
  There is only little available research and data on regional anesthesia procedures in specific immunosuppressed patient population. However, recent analyses from great databases dealing with general postoperative pain management have been published.
  
  
  CONCLUSIONS
  So far, there are no guidelines available dealing with indications and limitations of regional anesthetic procedures in these patients. The complication rate is rare but potentially disastrous. However, the technique itself cannot be regarded as absolute contraindication for immunosuppressed patients if precautions are taken. An interdisciplinary approach regarding the indication of regional anesthesia techniques in immunosuppressed patients is recommended. Efforts must therefore be made to achieve an interdisciplinary consensus with relevant risk-benefit considerations.
authors: Department of Anesthesiology and Intensive Care, University Hospital, Münster, Germany.
authors: Carsten
authors: C
authors: Gronwald
authors: Thorsten
authors: T
authors: Vowinkel
authors: Klaus
authors: K
authors: Hahnenkamp
mesh_terms: D000765:Anesthesia, Conduction / Q000379:methods*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D017053:Infection Control; D007239:Infections / Q000276:immunology*; D011183:Postoperative Complications / Q000276:immunology* / Q000517:prevention & control; D012306:Risk