RATIONALE
To describe the spinal anaesthetic implications and management of a parturient with poliomyelitis complicated scoliosis, who presented for emergency cesarean surgery.

CLINICAL FEATURES
A 31 year old female, with a H/O poliomyelitis and moderate restrictive lung disease, secondary to scoliosis, presented at 38 weeks gestation for emergency cesarean surgery. Based on the H/O full stomach, clinical examination of the patient, X-ray chest, X-ray lumbosacral spine and pulmonary function tests, Spinal Anaesthesia was selected as the best option.

In OT, patient was placed in sitting position. Under strict aseptic precaution, a 25G Quincke needle was introduced into L3-4 interspace which was located just above the right iliac crest due to severe scoliosis of spine. Spinal anaesthesia was administered by injecting 1.8ml of 0.5% BUPIVACAINE. Patient placed in supine position and a pillow placed under both thighs to compensate flexion deformity in both hips and knees. Sensory blockade confirmed by loss of sensation to pinprick below T7 dermatome. Patient delivered a male baby. Patient was comfortable and hemodynamically stable during surgical procedure.

DISCUSSION
Based on increased sensitivity to sedative drugs, prolonged effect of non-depolarizing relaxants, dysfunctional autonomic nervous system, altered anatomy of airway in scoliosis and full stomach status of patient, administration of spinal anaesthesia was decided as best option.

CONCLUSION
Spinal anaesthesia can be effectively performed in patients with poliomyelitis and scoliosis, provided undue care taken for patient positioning during anaesthesia and surgery.