Abstract- Failure of closure of neural tube during the 3rdweek of gestation leads to meningomyelocele.Infants with meningomyelocele may develop bacterial meningitis which is major indication for early(within 48hrs) surgery.Protection of exposed tissue from drying and trauma is essential.MMC(Meningomyelocele) is prenatally diagnosed by ultrasound in 2ndalfa feto protein may prompt fetalultrasound.Altough all MMC cases are associated with hind brain herniation(chiar II) malformation visualized on MRI.All MMC cases should be consulted with neurosurgeon for neurological abnormalities and the surgical treatment.As surgery is essential some time an anaestetic management should also be considerd in view of difficult intubation, respiratory assessment, neuromonitoring and large fluid loss. trimester.Positive screening for maternal.

METHODS : Thiopentone for induction of anaesthesia,intubated with positioning supine on soft rolls with uncuffed endotracheal tube,maintened on o2,n2o and isoflurane,atracuriumas muscle relaxant.intraoperative blood transfused, reversed with neostigmine and atropine.monitored heart rate, etco2, ecg, spo2.

RESULTS :Pt.Successfully Reversed And Extubated Uneventfully, Kept On O2 On Mask And Observation For 24 Hrs And Shifted To Ward After That.

CONCLUSIONS :Meningomyelocele Might Cause Some Problems In Anaesthetist Point Of View Like Difficult Intubation ,Positioning During Intubation , Thermoregulation, Fluid Or Blood Loss, Respiratory Difficulty Due To Brain Stem Compression But All These Problems Can Be Overcome By Careful Pre Operative Assessment Of The Case.

NAMES of all authors: Roberta L. Hines, KatherineeMarschall

AFFILIATIONS of all authors: YALE UNIVERSITY SCHOOL OF MEDICINE