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Anaesthetic Management of a Patient with Inguinal Hernia with Restrictive Lung Disease with Cor Pulmonale with Kyphoscoliosis

Vishnuvardhan Voleti, Rishabh Kumar

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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

How Cite This Article:

Rishabh Kumar, Vishnuvardhan Voleti. 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.

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Received : February 12, 2025         Accepted : April 10, 2025          Published : June 30, 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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Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

Conflicts of Interest

No conflicts of interest in this work.


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Cite this article

Rishabh Kumar, Vishnuvardhan Voleti. 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 30, 2025

DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.9

Keywords

Spinal anaesthesiaKyphoscoliosisRestrictive lung disease

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Received February 12, 2025
Accepted April 10, 2025
Published June 30, 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.


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