Chronic inflammatory demyelinating polyneuropathy (CIDP): immune-

mediated peripheral neuropathy characterized by progressive,

predominantly motor weakness, symmetric involvement of limbs and

sensory loss. It includes segmental demyelination of peripheral nerves,

endoneurial inflammatory infiltration and electrophysiological changes

Regional Anesthesia use is still a topic on debate due to the theoretical

risk of further neurological deficts and nerve injuries

METHODS

This case report describes the perioperative use of regional anesthesia on

a patient with CIPD. Informed patient consent obtained and exemption

from Institutional Review Board review per hospital policy.

Patient: 39y female, former tobacco user

Right lateral decubitus

position

USG guided sciatic

nerve block

No paresthesias or pain during needle advancement or injection.

Patient emerged uneventfully and was followed in the post-anesthesia care

unit + via telephone on postoperative day 1.

Analgesia persisted for approximately 18 hours, after which pain was

controlled with a single dose of oxycodone/acetaminophen.

No new neurologic deficits beyond baseline were observed following block

resolution

RESULTS

Patient: 39-year old female, BMI 22.7, stable baseline

Neurologic symptoms: primarily of bilateral plantar foot paresthesias

Surgery: Elective left foot fusion surgery

Anesthetic managment: general anesthesia + regional anesthesia

Preoperative area: Ultrasound-guided sciatic nerve block via popliteal

approach using 20 mL of 0.25% ropivacaine

No paresthesias or pain during needle advancement or injection.

Patient emerged uneventfully and was followed in the post-anesthesia care

unit + via telephone on postoperative day 1.

Analgesia persisted for approximately 18 hours, after which pain was

controlled with a single dose of oxycodone/acetaminophen.

No new neurologic deficits beyond baseline were observed following block

resolution

 

DISCUSSION

Regional anesthesia in patients with CIDP is supported by only a small

number of case reports

Decisions should be individualized, considering risk–benefit balance,

surgical requirements, and baseline neurologic status, with close

postoperative follow-up for early detection of complications.

Literature describes successful use of low local anesthetic concentrations

(0.2–0.25%) without neurologic sequelae; however, these doses may

provide analgesia rather than surgical anesthesia, supporting combination

with general anesthesia.

Risks and benefits should be fully disclosed.