Epidural Blood Patch in the HIV-positive Patient Review of Clinical Experience

Tom, Dari J.; Gulevich, Steven; Shapiro, Harvey M.; Heaton, Robert K.; Grant, Igor

doi:10.1097/00000542-199206000-00012

Cited by 98 publications

(29 citation statements)

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“…In certain situations (e.g., infection, leukemia, or other immunocompromise) it has been considered contraindicated to perform an autologous epidural blood patch, owing to risks of seeding the epidural or subarachnoid space with either infectious organisms or cancer cells [2,15,16]. Tom et al [17] discount this argument in the HIV-positive adult population; however, there are essentially no studies of a similar nature in children of which we are aware.…”

Section: Discussionmentioning

confidence: 99%

Perioperative headaches in an adolescent: a most complex situation

Campanini

Morrison

Ervin

2004

Journal of Adolescent Health

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Section: Discussionmentioning

confidence: 99%

Perioperative headaches in an adolescent: a most complex situation

Campanini

Morrison

Ervin

2004

Journal of Adolescent Health

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“…The indication of a blood patch (with autologous blood) after dural tap is considered to be safe, and it does not predispose to neurological disease progression (15).…”

Section: Infections Due To Virusesmentioning

confidence: 99%

Neuraxial Regional Anaesthesia in Patients with Active Infection and Sepsis: A Clinical Narrative Review

Gimeno

Errando

2018

Turk J Anaesth Reanim

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“…33 There is no contraindication to an epidural blood patch if indicated in the HIV-positive patient, although conservative management may be preferred. 7,34,35 2. General anaesthesia -Multiple drug interactions are possible, and may be difficult to predict.…”

Section: Anaesthetic Techniquementioning

confidence: 99%

Antiretroviral therapyand anaesthesia

Schulenburg

Roux

2008

Southern African Journal of Anaesthesia and Analgesia

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HIV has reached pandemic proportions in Southern Africa. Great emphasis is placed on the prevention and containment of HIV transmission by suppressing virus replication using highly active anti-retroviral therapy (HAART). HAART has proven to be highly effective if taken correctly, and has lead to increased life expectancy. Increasing numbers of HIV-positive patients on antiretroviral (ARV) therapy or HIV-exposed individuals taking prophylaxis present for surgery and critical care management. The anaesthesiologist should be familiar with the anaesthetic implications of HIV as well as the possible drug interactions while on ARV treatment. This article focuses specifically on the anaesthetic implications of the patient on HAART.HAART is HIV treatment with a combination of three or more ARV drugs from five broad classes. The specific HAART regimen in use in South Africa is considered in detail in this article. The pharmacokinetics of the ARV drugs is complex, and subject to interactions at many different sites. Serious drug interactions are possible, including drugs commonly used in anaesthesia. Drug interactions and recommendations are discussed in detail.ARVs are known to cause multiple systemic side effects, including lactic acidosis, Immune Reconstitution Inflammatory Syndrome (IRIS), premature atherosclerosis and increased cardiovascular risk, hyperlipidaemia, insulin resistance, skeletal disorders, hepatotoxicity, lipodystrophy, mitochondrial abnormalities, allergic reactions and pancreatitis.Non-compliance is common, and leads to the rapid development of resistance. The anaesthesiologist may inadvertently exacerbate this in the perioperative period. Recommendations regarding the interruption of treatment and fasting are made. Alternative routes for HAART administration are also explored. The management of the critically ill patient on a HAART regimen is discussed.

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Epidural Blood Patch in the HIV-positive Patient Review of Clinical Experience

Cited by 98 publications

References 0 publications

Perioperative headaches in an adolescent: a most complex situation

Perioperative headaches in an adolescent: a most complex situation

Neuraxial Regional Anaesthesia in Patients with Active Infection and Sepsis: A Clinical Narrative Review

Antiretroviral therapyand anaesthesia

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