Spinal anaesthesia in poliomyelitis patients with scoliotic spine: A case control study

Abstract

Background:There is limited data to predict the course of sub-arachnoid block in poliomyelitis patients with scoliotic spine. So we intended to study the course of intrathecal anaesthesia in these patients in comparison to patients with normal spine using 0.5% bupivacaine (heavy).Methods:In this prospective observational study, 41 poliomyelitic patients scheduled for lower limb corrective surgeries under spinal anaesthesia were enrolled. Patients were studied in two groups (Scolotic spine, n=20; Normal spine, n=21). All patients were injected 2 ml of 0.5% bupivacaine heavy intrathecally in the sitting position. The extent of block, bilateral spread, regression of sensory block and motor block were recorded. Demographic data were analysed using the unpaired t test or the chi square test as applicable. Block characteristics were analysed using the Mann Whitney U test.Results:There was statistically significant difference in bilateral spread of sensory block in between the groups. However, there was no significant difference in the maximum extent of the sensory block and the time taken for two segment regression of sensory block. There was no significant difference in time taken to reach complete motor block and for complete recovery from motor block to its preoperative value.Conclusions:Bilateral symmetrical spread of local anaesthetics through intrathecal route cannot be predicted accurately in patients with scoliotic spine. Spinal anaesthesia can be safely administered in poliomyelitis patients with scoliosis with less adverse effects.

Thoracolumbar curve and Cobb angle in determining spread of spinal anesthesia in Scoliosis. An observational prospective pilot study

“…Out of 21 patients in scoliotic group one case had inadequate block and was converted to general anesthesia. [ 7 ] However, we had neither measured the Cobb angle nor the side of thoracolumbar curve in scoliotic group.…”

“…Some case reports mentioned that spinal anaesthesia was safe in these patients compared to general anaesthesia. [ 4 5 6 ] We had little difficulty [ 7 ] in providing safe and effective spinal anaesthesia in these patients. We tried to evaluate the placement of spinal needle for spinal anaesthesia using goniometer.…”

Resurgence of Vaccine-Preventable Diseases in the United States: Anesthetic and Critical Care Implications

“…However, successful use of neuraxial anesthesia has been reported in patients with chronic disability because of polio or PPS. 152,155,156 Despite the potential risk of nerve injury, regional anesthetic techniques are a reasonable alternative to general anesthesia in some patients because of the unpredictability of neuromuscular blockade and risk of exacerbating respiratory compromise.…”

Response to Comments: Spinal anaesthesia in poliomyelitis patients with scoliotic spine: A case control study

“…We thank the reader for the critical comments on our article[12] The reason that we expressed that ‘until now there is no case series available’ similar to our study in our journal is because the case series reported by Hebl et al . [3] is a retrospective study aiming to show the feasibility and safety of providing regional anaesthesia in patients with pre-existing central nervous system disorders.…”