ABSTRACT : Poliomyelitis is a neuromuscular disorder caused by poliovirus (Enterovirus). This disease was largely eradicated from Western countries with the success of vaccination program, it is still a problem in tropical countries. Most commonly affected area are neuron in anterior horn of spinal cord. Poliomyelitis is associated with scoliosis in 30% of patient compared the general population which is 0.3-15.3%. Central neuraxial block is controversial in these patient with poses anaesthetic challenge of difficulties in palpating anatomical landmark, performing lumbar puncture, difficulty in predicting extent of block.

METHODS : 26 year old full term G2P1L1 with poliomyelitis scoliotic spine previous LSCS for CPD having fetal distress was admitted to hospital for emergency LSCS. On examination: Patient GPE–Normal, Height–140cm, Weight–45kg, BP–100/70, pulse–100 bpm, RR–10min. Systemic examination found to be normal, blood investigation and urine routine were in normal range. Peripheral venous access was secured with 18G canula was preloaded with RL 10ml/kg continuous ECG, NIBP and pulse oxymetry monitoring established. Patient was then placed in the lateral position and 23G quincke needle was introduced into L3–L4 space, clear CSF was obtained spinal anaesthesia was then administered by injecting 1.8ml of 0.5% Bupivacaine(H) adequate sensory block, upto T7 dermatome obtained. She was comfortable during the surgical procedure which was successfully completed.

RESULTS : SPINAL ANAESTHESIA IN A PARTURIENT WITH POLIOMYELITIS SCOLIOTIC SPINE is a challenging task but can be performed with skills.

CONCLUSIONS : There is always a possibility of symmetry in spread of sensory block in scoliotic patient with poliomyelitis but this usually goes without any clinically significant relevance. Choice of technique depends upon clinical assessment and individual judgement.