Anesthetic management of a patient with Eisenmenger syndrome: what next when one technique fails?

ABSTRACT

Though the condition Eisenmenger syndrome [ES] is quite rare, the patients may present for incidental surgeries. The anesthetic management is quite daunting in such patients since the physiological changes occurring during anesthesia may adversely affect the shunt. The perioperative mortality is quite high and ranges from 4% to 30%. The choice of anesthesia remains a controversial subject and the best technique is still not defined. We herein report a 23 year old male patient who was a known case of ES scheduled to undergo inguinal hernia repair. We planned the surgery under local anesthetic infiltration at the site and ilioinguinal nerve block. However the desired effect of local anesthetics was not obtained and the further anesthetic management of the patient was very challenging task