EPIDURAL ANAESTHESIA FOR PERI-OPERATIVE CARE OF MULTIPLE SCLEROSIS - A CASE REPORT
Multiple sclerosis is a disabling disease of the young adults typically affecting between 20-40 year of age. There is widespread damage to axons and demyelination in the CNS. Local anaesthetics have an exaggerated effect on the spinal cord in the presence of demyelination. The effects of stress, anaesthesia and surgery on the course of the disease are controversial. Effect of general anaesthesia is unpredictable while central neuraxial blocks have been implicated as possible causes of reactivation of disease . We report this case in which patient was scared of general anaesthesia because of her previous bad experience. Most of the studies contradict the use of spinal anaesthesia in multiple sclerosis because of prolonged paralysis and refractory hypotension;  therefore we planned epidural anaesthesia.