Contraindications of neuraxial block (Spinal and Epidural anaesthesia)

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Absolute contraindications: 

  • Patient refusal 
  • Infection at the site of injection 
  • Drug allergy 
  • Coagulopathy and thrombocytopenia 
  • Severe hypovolemia 
  • Increased intracranial pressure (ICP)

Relative contraindications: 
  • Sepsis 
  • Stenotic valvular heart disease 
  • Left ventricular outflow tract obstruction (hypertrophic obstructive cardiomyopathy or fixed cardiac output state)
  • Uncooperative patient 
  • Preexisting neurological deficit 
  • Indeterminate neurological disease 
  • Demyelinating lesions (multiple sclerosis) 
  • Severe spinal deformity 

Controversial:
  • Previous back surgery at the site of injection 
  • Complicated surgery 
  • Prolong surgery 
  • Major blood loss 
  • Maneuver that compromise respiration 
Source: 
Morgan & Mikhail's Clinical Anesthesiology, 6e
Nysora 

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