P025 Regional anesthesia for rotator cuff repair surgery in poliomyelitis patient, case report

<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted</b>: Not relevant (see information at the bottom of this page) <h3>Background and Aims</h3> Polio, or poliomyelitis, is a disabling and life-threatening disease caused by the poliovirus. An important consideration in the anesthetic management of patients with PPS is whether regional anesthesia is safe. Many anesthesiologists are hesitant to use regional anesthesia in patients with preexisting neuromuscular deficits, because of the concern of exacerbating existing disease or difficulty evaluating complications. <h3>Methods</h3> We present a case of right shoulder arthroscope for rotator cuff muscles repair under regional anesthesia combined with general anesthesia in semi-sitting position for 47-year-old male patient with poliomyelitis, ASA III, smoker, weight 117.5 kg, height 146 cm, BMI 53. The anesthesia plan for his shoulder surgery is ultrasound guided right interscalene block combined with general anesthesia without using muscle relaxants. Ultrasound guided right interscalene block C5-6 root level while patient awake on his lateral position without any complications. The local anesthesia used for interscalene block is Bupivacaine 0.25% and 2% lidocaine of total 7 ml were injected. <h3>Results</h3> Ultimately, the decision to use general or regional anesthesia should be made on an individual patient basis weighing the risks and benefits. If a spinal anesthetic is selected, a medication with a long history of safety, such as hyperbaric bupivacaine, should be used. <h3>Conclusions</h3> Our conclusion is that post-polio patients may display altered sensitivity to any of the medications commonly used for regional and general anesthesia. Once aware of these considerations, anesthesiologists are better prepared to provide safe care, not only to patients with PPS, but to any patient with a history of poliomyelitis.