Choice of Anaesthesia in Patient with Severe Pulmonary Hypertension Scheduled for Orthopaedic Surgery – A Case Report

Anaesthesia in surgical patient with severe pulmonary hypertension is very challenging. It needs to weigh pros and cons of choice of anaesthetic technique. A little pendulum shift on either side can prove catastrophic. A 45 years male with severe pulmonary hypertension scheduled for internal fixation of fracture of neck of femur was managed successfully under graded epidural anaesthesia. We discuss pros and cons of anaesthetic technique and importance of invasive monitoring and meticulous intraoperative fluid and paus management to achieve desirable outcome.