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Indian Journal of Anesthesia and Analgesia 12(2):p 133-135, April -June 2025. | DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.9
Case Report
Anaesthetic Management of a Patient with Inguinal Hernia with Restrictive Lung Disease with Cor Pulmonale with Kyphoscoliosis
Rishabh Kumar, Vishnuvardhan Voleti
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Anesthesia and Analgesia 12(2):p 133-135, April -June 2025. | DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.9
How Cite This Article:
Kumar R, Voleti V. Anaesthetic management of a patient with inguinal hernia with restrictive lung disease with cor pulmonale with kyphoscoliosis. Ind J Anesth Analg. 2025;12(2):133-135.Timeline
Received : February 12, 2025
Accepted : April 10, 2025
Published : June 23, 2025
Abstract
Introduction: Kyphoscoliosis is a forward and lateral bending of the spine,. Kyphoscoliosis causes a decrease in functional residual capacity, inspiratory capacity, vital capacity, and total lung capacity leading to restrictive pattern. Restrictive lung disease, airway management, and cardiorespiratory embarrassment make general anesthesia hazardous, whereas regional anesthesia is met with technical problems due to an abnormal curvature of the spine. Case Report: A 53 year old male diagnosed as indirect inguinal hernia was posted for Hernioplasty, Patient is a Known case of Restrictive lung disease with Cor pulmonale since 3 years and was admitted and intubated in ICU 2 months before the surgery in view of respiratory distress and low GCS. On Pre-anaesthetic examination vitals were stable, airway assessment showed large tongue with MP Grade 4 with prominent anterior larynx. investigations were normal. PFT showed early small airway obstruction. Spine examination was done and there was thoracolumbar scoliosis with spine curve to left and body lean to right. Under all aseptic conditions, lumbar puncture was done at L3-L4 space with 25G quickie needle, after confirming the back flow of CSF 3.4 ml of 0.5% hyperbaric Bupivacaine with 0.2 ml of Buprenorphine was given, but it failed as motor and sensory block was not achieved after 20 minutes of observation, Sub arachnoid block was reattempted through paramedian approach, patient was made supine, sensory block was checked which was achieved till T6. surgery was performed, No major hemodynamic changes were noted. after surgery, patient was monitored in Post-anaesthesia Care Unit and then shifted towards. Conclusion: In a patient with Kyphoscoliosis and Restrictive lung disease Regional Anaesthesia is preferred over General anaesthesia considering risks and benefits.
References
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- 2. Misra S., Shukla A., Rao K.G. Subarachnoid block in kyphoscoliosis: A reliable technique?. Medical Journal of Dr. D.Y. Patil University. 2016 1; 9(6): 761-4.
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- 4. Veliath D.G., Sharma R., Ranjan R.V., Rajesh Kumar C.P., Ramachandran T.R. Parturient with kyphoscoliosis (operated) for caesarean section. J Anaesth Clin Pharmacol. 2012; 28: 124-6.
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Author Contributions
All authors contributed significantly to the work and approve its publication.
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This article does not involve any human or animal subjects, and therefore does not require ethics approval.
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Cite this article
Kumar R, Voleti V. Anaesthetic management of a patient with inguinal hernia with restrictive lung disease with cor pulmonale with kyphoscoliosis. Ind J Anesth Analg. 2025;12(2):133-135.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| February 12, 2025 | April 10, 2025 | June 23, 2025 |
DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.9
Keywords
Spinal anaesthesiaKyphoscoliosisRestrictive lung diseaseSearch for Similar Articles
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Timeline
| Received | February 12, 2025 |
| Accepted | April 10, 2025 |
| Published | June 23, 2025 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
