Journal of Anesthesia

, Volume 28, Issue 2, pp 267–278

Multiple sclerosis: basic knowledge and new insights in perioperative management


    • Department of AnesthesiologyAsklepieion Hospital of Voula
  • Alexandros Piperopoulos
    • Department of AnesthesiologyAsklepieion Hospital of Voula
  • Iosifina Karmaniolou
    • Department of AnesthesiaRoyal National Orthopaedic Hospital
Review Article

DOI: 10.1007/s00540-013-1697-2

Cite this article as:
Makris, A., Piperopoulos, A. & Karmaniolou, I. J Anesth (2014) 28: 267. doi:10.1007/s00540-013-1697-2


Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system affecting young adults that may lead to significant disability. The clinical course varies among the types of the disease as well as among individuals. Herein we provide a brief review of the recent data concerning the clinical presentation, diagnosis, causes, and pathogenesis of MS as well as medication used, followed by the anesthetic considerations of patients diagnosed with the disease. To accomplish this, we conducted a systematic PubMed literature search for articles, using the terms multiple sclerosis, anesthesia, general, regional, perioperative, and preoperative, and we then manually reviewed the references from each pertinent article. Because randomized controlled trials on the field are rare, most information is derived by case reports and case series. We concluded that the disease itself as well as the treatment modalities may have several implications in the conduct of anesthesia and perioperative management of MS patients. General and regional anesthetic techniques have been successfully used. With thorough preoperative evaluation and in depth knowledge of the disease and its complications, the MS patients can be managed safely.


Multiple sclerosisGeneral anesthesiaRegional anesthesia

Copyright information

© Japanese Society of Anesthesiologists 2013