Anaesthetic Management of the Obstetric Patient with Neurological Disease

SUMMARY

Provision of proper anaesthetic care to the pregnant patient with neurological disease requires a thorough understanding of the pathophysiology of the disorder and careful documentation of the patient's history and neurological examination. In most cases, regional anaesthesia can be safely administered. The anaesthesiologist should establish good rapport with the patient, while providing an adequate explanation of the known risks and benefits of the anaesthetic procedure. This should avoid any potential medico-legal complications regarding the effect of the anaesthetic on the neurological disorder. Too often, these patients are denied appropriate anaesthetic management because of these concerns. In the words of Dr J. S. Crawford: ‘Good medical practice must not be constrained or diminished by rapacious lawyers or ill-informed opinion’ (Crawford, 1983).