Severe uncorrected hypovolemia is an absolute contraindication to neuraxial anesthesia because the sympathetic blockade caused by the regional anesthetic can lead to profound and life-threatening hypotension in an already volume-depleted patient, potentially resulting in cardiovascular collapse. Patient on therapeutic aspirin therapy is generally not an absolute contraindication for neuraxial blocks, though other antiplatelets or anticoagulants might be. Pre-existing peripheral neuropathy and previous lumbar spine surgery are typically considered relative contraindications, requiring careful consideration, risk-benefit assessment, and discussion with the patient, but they do not universally preclude neuraxial anesthesia.
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