Indian Journal of Anaesthesia  
About us | Editorial board | Search | Ahead of print | Current Issue | Past Issues | Instructions
Home | Login  | Users Online: 2708  Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size    




 
 Table of Contents    
LETTER TO EDITOR
Year : 2013  |  Volume : 57  |  Issue : 6  |  Page : 637-638  

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


Department of Anaesthesia, Tata Motors Hospital, Jamshedpur, Jharkhand, India

Date of Web Publication20-Dec-2013

Correspondence Address:
Ashok Jadon
Duplex-63, Vijaya Heritage, Phase-6, Kadma, Jamshedpur - 831 005, Jharkhand
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.123358

Rights and Permissions

How to cite this article:
Jadon A. Comment on "Spinal anaesthesia in poliomyelitis patients with scoliotic spine: A case control study". Indian J Anaesth 2013;57:637-8

How to cite this URL:
Jadon A. Comment on "Spinal anaesthesia in poliomyelitis patients with scoliotic spine: A case control study". Indian J Anaesth [serial online] 2013 [cited 2019 Dec 11];57:637-8. Available from: http://www.ijaweb.org/text.asp?2013/57/6/637/123358

Sir,

I read with interest the recently published article in Indian Journal of Anaesthesia "Spinal anaesthesia in poliomyelitis patients with scoliotic spine: a case control study" by Kumari et al. [1] I congratulate the authors for their research work however; I have to make few comments.

  1. Authors have mentioned that there is no case series available, is not appropriate. Hebl et al. [2] published a case series of 139 patients including 79 patients of Post-poliomyelitis (56.4%).
  2. The reference Hebl et al. [2] is also mentioned in wrong context in present article. It is mentioned that central neuraxial block is controversial due to difficulties in palpating landmarks, high risk of dural puncture and unpredictable extent of block. In fact, Hebl JR et al. have concluded that the risks commonly associated with neuraxial anaesthesia and analgesia in patients with preexisting CNS disorders may not be as frequent as once thought and that neuraxial blockade should not be considered an absolute contraindication within this patient population.
  3. Authors have observed that high level of disparity in sensory block was present among scoliotic patients. They have also suggested that, this disparity is due to curve in spinal canal resulted in an unequal ascend of block. However, it is not very clear that which side patients have higher block, either the convex side or concave side. This important Information would be quite helpful to position the patient as per requirement of block height.
  4. Authors have used midline puncture for spinal with cent percent success, which is commendable. In our experience we have observed that scoliosis of spine in isolation is rare and it is associated with some amount of kyphosis and in combination (rotated spine). At times it is impossible to insert spinal needle from midline and we have to resort to paramedian, Taylor's approach or fluoroscopic guide for conduct of anaesthesia [Figure 1]. [3] However, authors did not mention the amount of difficulty during spinal punctures at all.
    Figure 1: Severe scoliosis of spine with rotational deformity requires other approaches than midline approach

    Click here to view


 
   References Top

1.Kumari BG, Samantaray A, Kiran Kumar VA, Durga P, Jagadesh G. Spinal anaesthesia in poliomyelitis patients with scoliotic spine: A case control study. Indian J Anaesth 2013;57:145-9.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Hebl JR, Horlocker TT, Schroeder DR. Neuraxial anaesthesia and analgesia in patients with preexisting central nervous system disorder. Anesth Analg 2006;103:223-8.  Back to cited text no. 2
[PUBMED]    
3.Jadon A, Chakraborty S, Sinha N and Kedia S: Continuous caudal epidural anaesthesia for vaginal hysterectomy in a patient of heart disease and severe spinal deformity; a case report. Journal of Anesthesiology and Clinical Science 2013;2. Available at: http://dx.doi.org/10.7243/2049-9752-2-15. Accessed on 3.07.2013.  Back to cited text no. 3
    


    Figures

  [Figure 1]


This article has been cited by
1 response to comments: spinal anaesthesia in poliomyelitis patients with scoliotic spine: a case control study
kumari, b.g. and samantaray, a. and kumar, a.k. and durga, p. and jagadesh, g.
indian journal of anaesthesia. 2013; 57(6): 638-639
[Pubmed]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Figures

 Article Access Statistics
    Viewed1622    
    Printed9    
    Emailed0    
    PDF Downloaded299    
    Comments [Add]    
    Cited by others 1    

Recommend this journal