Poonuraparampil Joseph A, Karim Habib Md R, Nayak Pratyasha, Vijapurkar Swati, Sandeep Gade
Anesthesiology, Manipal Tata Medical College, Manipal Academy of Higher Education (MAHE), Jamshedpur, IND.
Anesthesiology, Critical Care, and Pain Medicine, All India Institute of Medical Sciences, Deoghar, IND.
Cureus. 2023 Aug 22;15(8):e43913. doi: 10.7759/cureus.43913. eCollection 2023 Aug.
The Western world has been polio-free for decades; however, many are affected by the stigmata of polio in several countries, including India. While general anesthesia (GA) and subarachnoid block (SAB) have been used successfully and widely, all those cases were mostly done with relatively older drugs and without additives. Therefore, further literature is needed to note the effect of newer anesthetic agents on post-polio paralytic patients for both GA, viz., propofol, fentanyl, rocuronium, and desflurane, and SAB with intrathecal hyperbaric bupivacaine and adjuvants. We report three male cases from Central India, in their 40s, with post-polio residual paralysis (PPRP), sarcopenia, and deformity of the lower limb and scoliosis; one case was managed under GA using desflurane-based low-flow anesthesia technique, and the other two under SAB, one with intrathecal fentanyl as an adjuvant to bupivacaine and the other without an adjuvant. The case series describes the effect of these modern-day anesthetic drugs and techniques.
西方世界已经数十年没有脊髓灰质炎了；然而，在包括印度在内的几个国家，许多人仍受到脊髓灰质炎后遗症的影响。虽然全身麻醉（GA）和蛛网膜下腔阻滞（SAB）已被成功广泛应用，但所有这些病例大多使用的是相对较老的药物且没有添加剂。因此，需要更多文献来记录新型麻醉剂对脊髓灰质炎后麻痹患者在GA（即丙泊酚、芬太尼、罗库溴铵和地氟烷）以及使用鞘内高压布比卡因和佐剂的SAB方面的影响。我们报告了来自印度中部的三例男性病例，年龄在40多岁，患有脊髓灰质炎后残留麻痹（PPRP）、肌肉减少症、下肢畸形和脊柱侧弯；一例在GA下采用基于地氟烷的低流量麻醉技术进行处理，另外两例在SAB下处理，一例使用鞘内芬太尼作为布比卡因的佐剂，另一例未使用佐剂。该病例系列描述了这些现代麻醉药物和技术的效果。
