ABSTRACT
Gilbert's syndrome is a form of hereditary non-hemolytic jaundice transmitted by autosomal dominant pattern. Since there is low glucuronyl transferase activity in the liver there is a risk for anesthetic toxicity with a possibility of a catastrophic outcome. It is important for the anesthesiologists to understand the pathophysiology of the disease and the conditions leading to decreased glucuronyl transferase activity. We report a case of Gilbert's syndrome with hypertension, operated for cholelithiasis under thoracic epidural analgesia supplemented with transcutaneous electrical nerve stimulation in the postoperative period. Minimal administration of intravenous drugs, maintaining the organ perfusion and postoperative pain relief using epidural anesthesia offers a safe conduct of anesthesia which can be considered as an alternative to general anesthesia