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 confrming the back ?ow 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 benefts.